A new double graft technique in urethroplasty for complex urethral stenosis: preliminary findings

Abstract

The management of complex urethral stenosis may involve different surgical techniques. As retraction of the graft may account for surgical failure, this risk increases in patients with more extensive stenosis requiring a graft of greater diameter. Although double grafts have already been used to maximize success in these cases, we propose a modifi ed technique for urethroplasty with longitudinal urethral incision. The hypothesis was that this technique would increase the lumen by using only a urethral incision on the dorsal surface. Two patients presenting with recurrent urethral stenosis underwent urethroplasty using a double graft of oral mucosa that preserves the integrity of the spongy tissue and allows ventral inlay graft fi xation using a midline relaxing incision in the portion of the urethra with stenosis. In both cases, the urethrocystoscopy and urofl owmetry performed after surgery showed a pervious and complacent urethra. After four and six months of follow-up, the postoperative outcomes were satisfactory for both patients. Further studies involving larger numbers of patients and long-term follow-up are required to evaluate the effectiveness of this method.

Non-Transecting Urethroplasty for Bulbar Urethral Strictures—Narrative Review and Treatment Algorithm

“…Similarly, a dorsal urethrotomy is made through which the ventral urethral mucosa is incised, and a BMG may be inlayed followed by a dorsal onlay ( Figure 4 ). This has the proposed benefit of minimizing trauma to the thicker ventral spongiosum and providing a backing for the ventral graft [ 32 ].…”