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Related Experiment Videos

Urethroplasty following total phallic reconstruction

L A Levine1, L Elterman

  • 1Department of Urology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.

The Journal of Urology
|July 29, 1998
PubMed
Summary

Buccal mucosa urethroplasty shows promise for treating urethral strictures after phallic reconstruction, with superior urinary flow rates and no recurrence. This technique offers a viable option for complex cases where traditional methods fail.

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Area of Science:

  • Urology
  • Reconstructive Surgery
  • Microsurgery

Background:

  • Total phallic reconstruction can lead to urethral strictures, particularly at the anastomosis site.
  • Ischemia and kinking at the neophallus base exacerbate stricture formation.
  • Traditional urethroplasty techniques are often unsuitable for these complex cases.

Purpose of the Study:

  • To review the experience with penile reconstruction in 15 patients with urethral strictures.
  • To evaluate the effectiveness of various urethroplasty techniques, focusing on extragenital grafts and flaps.
  • To identify promising approaches for managing urethral strictures in the neophallus.

Main Methods:

  • 15 patients (17-50 years old) underwent phallic reconstruction using radial forearm or fibula flaps.

Related Experiment Videos

  • Nine urethroplasties were performed on 8 patients, utilizing techniques such as mesh grafts, skin tubes, bladder mucosa, labial flaps, and buccal mucosa onlay grafts.
  • Stricture lengths varied from 3 to 12 cm, with urethroplasty performed 2-34 months post-construction.

    • Main Results:

    • Buccal mucosa urethroplasty resulted in an average urinary flow rate of 18 cc/sec.
    • No strictures recurred in patients treated with buccal mucosa grafts.
    • These outcomes were superior to other urethroplasty techniques used in this cohort.

    Conclusions:

    • A comprehensive range of surgical options is essential for reconstructive surgeons.
    • Buccal mucosa grafting emerges as a highly promising approach for urethral strictures in patients with reconstructed phalluses.
    • This technique addresses the unique challenges of the recipient bed in neophallus repairs.