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[Skin graft urethroplasty]
N Gaschignard1, D Prunet, N Vasse
1Clinique Urologique, Hôtel-Dieu, Nantes, France.
Summary
Skin graft urethroplasty (SGU) shows a 67.9% success rate for urethral strictures, with sterile urine being a key factor. Recurrences were managed with various techniques, indicating SGU
Area of Science:
- Urology
- Surgical Innovation
Background:
- Urethral stricture disease affects numerous patients, necessitating effective surgical interventions.
- Skin graft urethroplasty (SGU) is a reconstructive option for managing urethral strictures.
Purpose of the Study:
- To evaluate the efficacy and outcomes of skin graft urethroplasty (SGU) in patients with urethral stricture.
- To identify factors influencing the success of SGU for urethral stricture management.
Main Methods:
- Retrospective review of 28 patients undergoing SGU for urethral stricture.
- Mean follow-up of 24.5 months; skin graft materials included foreskin, penile, or arm skin.
- Assessment of clinical outcomes, uroflowmetry, and need for salvage surgery.
Main Results:
- Satisfactory results (no recurrence, flow rate >= 15 ml/s, no salvage surgery) achieved in 67.9% of cases.
- Low early complication rate, but 8 subsequent stenoses occurred; 3 required revision surgery.
- Urine sterility at the time of surgery was identified as a decisive factor for successful outcomes.
Conclusions:
- SGU is a viable option for bulbar urethral strictures, particularly when urine is sterile pre-operatively.
- Stricture etiology and length were not found to be significant factors in predicting SGU success.
- Recurrent strictures were managed effectively with internal urethrotomy or dilatations.