Penile fasciocutaneous flap urethroplasty: recent experience and challenges in a sub-Saharan African teaching hospital
K H Tijani1, A A Adesanya, C N Ogo
1Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria. habeeb_tijani@yahoo.com
Objective:
To evaluate penile fasciocutaneous flap urethroplasty for complex anterior urethral strictures in circumcised West African men.
Methods:
Between January 2002 and December 2006, 26 patients with anterior urethral strictures underwent penile fasciocutaneous flap urethroplasty (PFU), using a modification of the technique described by Quartey (Quartey JKM. J Urol. 1985;134:474-475). Of these patients, 21 had dorsal onlay patches and 5 had tubularize patches. Average follow-up was 19 months.
Results:
There was a 100% immediate success rate with the dorsal onlay group. No recurrence was seen in all patients available for follow-up at 30 months. The tubularized flap had an immediate success of 80% but at 30 months it was only 40%. Troublesome postvoid dribbling was completely eliminated and complications were minor and few, which included 1 case of distal superficial dorsal penile skin loss, 1 case of urethrocutaneous fistula, and 2 cases of postvoid dribbling all of which were managed conservatively.
Conclusions:
PFU when used as a dorsal onlay gives excellent results at least in the immediate and intermediate periods in black West African population. A multiracial study to compare the effect of skin color on the short- and long-term outcome of PFU is also suggested.
