Patch autografts in the treatment of urethral stricture

Single-stage skin patch urethroplasty has become accepted therapy for urethral stricture. Review of the literature and the authors' experience indicated good short-term clinical results (80%), but the fate of the implanted tissue has not been well documented. Twenty-three skin and vein patch autograft repairs of defects created in the rabbit urethra were examined histologically after 4 weeks in situ. Two of 12 skin grafts remained intact while 9 of 11 vein patches were successful. The vein patch autograft appears to provide better support because of the survival of the elastic and smooth muscle tissues. Unlike skin grafts, which retain their squamous epithelium, the venous endothelium is entirely replaced by urothelium, thus decreasing potential neoplastic degeneration, and the incidence of fistula formation, fibrosis and chronic inflammation. Further investigation is required before introducing the vein patch urethroplasty into clinical practice.