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Urethral Stricture Induction Followed by Buccal Mucosa Graft Urethroplasty in a Rat Model

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Comparative study of urethroplasties to reduce urethral strictures in patients with severe hypospadias

Li-Qu Huang¹, Jun Wang¹, Zheng Ge¹

¹1 Department of Urology, Children's Hospital of Nanjing Medical University, Nanjing, China.

The Journal of International Medical Research

|February 13, 2019

Abstract

Objective:

Transverse island pedicle flap (TIPF) plus transected urethral plate-preserving urethroplasty is increasingly used for treatment of severe hypospadias. We aimed to reduce the occurrence of urethral strictures in patients undergoing such procedures.

Methods:

Sixty-five patients with severe hypospadias were enrolled. Thirty-two patients underwent onlay-tube-onlay urethroplasty (Group A), and 33 patients underwent modified Duplay urethroplasty (Group B). Postoperative complications were recorded, including fistulas, urethral strictures, and diverticula.

Results:

Three patients (9.4%) in Group A and 10 patients (30.3%) in group B had urethrocutaneous fistulas. Three patients (9.4%) in Group A and 0 patients (0%) in Group B had urethral strictures. No patient in the two groups had symptoms of diverticulum or penile chordee. The results of uroflowmetry were better in Group B than Group A, when comparing uroflow patterns.

Conclusions:

TIPF plus transected urethral plate-preserving urethroplasty can lower the occurrence of stricture, which is a challenging complication. The occurrence of stricture was lower in patients who underwent modified Duplay urethroplasty, and neourethral function and quality were better in these patient. Thus, this modified procedure can be used for treatment of severe hypospadias.

Keywords:

Severe hypospadias diverticulum fistula flap transected urethral plate urethral stricture urethroplasty uroflowmetry

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