Bulbar urethroplasty using the dorsal approach: current techniques

Barbagli, Guido; Palminteri, Enzo; Guazzoni, Giorgio; Cavalcanti, André G.

doi:10.1590/s1677-55382003000200012

Cited by 27 publications

(21 citation statements)

References 23 publications

(36 reference statements)

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“…93,94 Proponents of dorsal grafting, on the other hand, argue that the corpus spongiosum provides greater mechanical support for dorsal onlay and, therefore, a reduced risk of diverticula formation, as well as offering a larger calibre of reconstructed urethra and the opportunity for neovascularization. 95 Several studies have shown similar success rates for dorsal and ventral onlay grafting, 93,94,96–103 ranging from 84–100%. 68,104–106 …”

Section: Managementmentioning

confidence: 96%

Male urethral strictures and their management

2013

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Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques.

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Section: Managementmentioning

confidence: 96%

Male urethral strictures and their management

2013

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“…In addition, the width of the lip (maximal dimension, 1 ϫ 4 cm), unlike the buccal mucosa (maximal dimension, 3 ϫ 5.5 cm), limits the size of the graft. [1,37,38] …”

Section: Buccal and Labial Mucosaementioning

confidence: 99%

Oral mucosa grafts for urethral reconstruction

Mungadi

Ugboko

2009

Ann Afr Med

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Background: Urethral reconstruction has continued to present formidable and enormous challenges for urologic, paediatric and plastic surgeons as diverse opinions have been expressed on the quality and type of ideal substitution material. This literature review is aimed at drawing attention of surgeons to the versatile nature of oral mucosal grafts. Methods: A review of the utilization of oral mucosa in urethral reconstruction was made. Structured Medline search was performed looking at all aspects of utilization of oral mucosa including mucosal harvest, donor site morbidity and outcome. Results: The unique demands of the urethra set a high standard for autogenous graft substitutes; hence literature reports reveal that split and full thickness skin grafts from the scrotum, penis, extragenital sites (ureter, saphenous vein, appendix, colon, medial upper arm, neck, lateral chest, abdomen, bladder mucosa) and more recently oral mucosa have been used. Unlike other tissues, oral mucosa grafts are fl exible, easy to harvest and trim and have an excellent microvasculature favorable for graft-taking. Furthermore, the natural moist location of the oral mucosa in the oral environment favours its easy adaptability in the urethral passage thus giving good long-term results. However, there are reports of complications at the donor site with the commonest being anaesthesia or paraesthesia of the cheek or lips. Regional variations of the oral mucosa, length of the graft required, the decision to close or leave donor site open and harvesting technique are some of the factors suggested to account for differences in donor site morbidity. Conclusion: Oral mucosal graft is a versatile urethral substitute with excellent outcome. It is becoming the gold standard for urethral substitution.

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“…To reconstruct significant parts of the penis itself musculocutaneous flaps are needed [62]. For reconstruction of urethral defects full-thickness skin grafts may show poor results, whereas buccal mucosa has been used with good results [75,76].…”

Section: Perineo-genital Defectsmentioning

confidence: 99%

Necrotizing Fasciitis of the Perineum and the Abdominal Wall-Surgical Approach

Ecker¹,

Baars²,

Töpfer³

et al. 2008

Eur J Trauma Emerg Surg

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Necrotizing fasciitis is a synergistic aerobical-anaerobical infection that rapidly spreads from its origin leading to foudroyant increasing soft tissue gangrene and systemic sepsis. In the perineal, perianal and genital regions it is referred to as Fournier's gangrene constituting a clinical entity with the gangrene of the abdominal wall. After a short presentation of the own experience with 17 patients the surgical approach to the life-threatening disease is presented reviewing the former and the recent literature. There is a worldwide consensus that immediate radical excision of the gangrene should be accompanied by intensive care measures. Functional and cosmetic defects are to be reconstructed in a second stage. However, morbidity and mortality remain high in spite of consequent treatment due to often associated significant co-morbidity of affected patients.

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Bulbar urethroplasty using the dorsal approach: current techniques

Cited by 27 publications

References 23 publications

Male urethral strictures and their management

Male urethral strictures and their management

Oral mucosa grafts for urethral reconstruction

Necrotizing Fasciitis of the Perineum and the Abdominal Wall-Surgical Approach

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