[Urethroplasty in long strictures of the anterior urethra]

Strictures of the male urethra are always very serious therapeutic problem, regardless of their localization. The presence of variety of surgical modalities for their treatment, impose the need for differentiated approach and clear criteria for their use. Particularly interesting for the clinicians and the researchers are the long strictures of the anterior urethra

For period of 12 years (1992-2004) 56 patients with urethral strictures were diagnosed, operated and followed. Of them 38 (67.9%) have stricture of the anterior urethra and 18 (32.1%) strictures of posterior urethra. In patients with stricture of the anterior urethra in 16(42.1%) the length of the stricture was between 2 and 5 cm, in 13 (34.2%) over 5 cm, and in 9 (23.7%) had multiple strictures. In patients with length of the stricture over 5 cm three surgical modalities of urethroplasty were mainly applied: free buccal mucosa graft--7 (53.8%); pediculated preputial flap--4 (30.8%) and longitudinal ventral skin flap--2 (15.4).

Late results of the treatment of patients with long strictures of the anterior urethra show that in 76.9% of cases there is good and lasting patency of the urethra. In 2 cases (15.4%) formation of pseudodiverticula was observed, in another 2 (15.4%)--restrictures in the site of anastomosis, and in 1 (7.7%)--formation of urethral fistula.

The long strictures of the urethra are extremely serious therapeutic problem, which demands a precise choice of the surgical technique for their treatment. The introduction in practice of the buccal mucosa graft urethroplasty sharply improved the options for treatment of this disease.