Experience with two-stage scrotal flap urethroplasty for stricture

Area of Science:

• Urology
• Surgical Innovation

Background:

• Urethral stricture, particularly in the bulbar and membranous regions, presents a significant clinical challenge.
• Previous surgical techniques for urethral reconstruction have varying success rates and complication profiles.

Purpose of the Study:

• To evaluate the efficacy and safety of a 2-stage scrotal flap urethroplasty for treating urethral stricture.
• To assess post-operative voiding function and recurrence rates.

Main Methods:

• A series of 50 men with bulbar and/or membranous urethral stricture underwent a 2-stage scrotal flap urethroplasty.
• Post-operative outcomes including incontinence, recurrence, and voiding function were assessed.

Main Results:

• The 2-stage scrotal flap urethroplasty was technically straightforward with no significant post-operative incontinence.
• Recurrence or new strictures occurred in 7 cases (14%), with 5 successfully managed by internal urethrotomy.
• Improved voiding was observed in all 18 patients who underwent pre- and post-operative timed micturition.
• Urodynamic studies in 8 patients demonstrated significantly improved urinary flow, reduced detrusor pressure, and decreased residual urine post-operatively.

Conclusions:

• The 2-stage scrotal flap urethroplasty is a safe and effective treatment for bulbar and membranous urethral strictures.
• The procedure leads to significant functional improvements in urinary flow and voiding.
• Internal urethrotomy serves as a viable option for managing short recurrences.