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Related Experiment Videos

Changing practice in anterior urethroplasty.

T J Greenwell1, S N Venn, A R Mundy

  • 1Institute of Urology, London, UK.

BJU International
|May 8, 1999
PubMed
Summary

For penile urethral repair, two-stage free graft procedures offer superior outcomes compared to one-stage flaps, especially for circumferential reconstructions. Buccal mucosal grafts are recommended for uncomplicated bulbar urethral strictures.

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Area of Science:

  • Urology
  • Reconstructive Surgery

Background:

  • Anterior urethral strictures require surgical reconstruction.
  • Treatment practices have evolved, shifting from one-stage flap repairs to two-stage free graft procedures.

Purpose of the Study:

  • To evaluate the outcomes of penile urethral repair and reconstruction.
  • To document the transition in surgical techniques from one-stage flap to two-stage free graft procedures.

Main Methods:

  • Retrospective review of 79 patients undergoing anterior urethroplasty between 1992 and 1996.
  • Analysis of one-stage bulbar patch urethroplasties (n=45) and penile urethroplasties (n=34).
  • Comparison of outcomes between buccal mucosal free grafts and local skin flaps, and between one-stage and two-stage repairs.

Main Results:

  • Buccal mucosal free grafts demonstrated comparable or superior results to local skin flaps for patch urethroplasty.
  • Two-stage repairs yielded significantly better outcomes than one-stage repairs for total circumferential penile urethral reconstruction.

Conclusions:

  • Buccal mucosal free grafts are the preferred material for uncomplicated bulbar urethral patch urethroplasty.
  • The Orandi procedure remains the gold standard for uncomplicated penile urethral patch strictures.
  • Two-stage free graft repairs are superior to one-stage flap repairs for circumferential urethral reconstruction, particularly in the penile urethra.

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