60 Novel Two-Stage Penile Urethroplasty Utilizing Ventral Urethrotomy and Dorsal Buccal Mucosa Inlay With Lateralization and Preservation of the Urethral Plate

McClung, Chris; Hotaling, Jim; Voelzke, Bryan B.; Wessells, Hunter

doi:10.1016/j.juro.2010.02.107

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“…This can be done in the fashion of Schreiter's work, by placing grafts lateral to the urethral plate. procedure to be used in a two-stage approach [ 18 ]. In this method the strictured urethral segment was mobilized in a circumferential fashion and then split ventrally and dorsally, resulting in two halves of the urethral plate.…”

Section: Modern Surgical Variations Of Staged Urethroplastymentioning

confidence: 99%

Staged Urethroplasty

McClung¹,

Wessells²

2013

Advanced Male Urethral and Genital Reconstructive Surgery

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SummaryStaged urethroplasties are characterized by a planned repair involving more than one surgery to fi x a urethral stricture, obliteration, diverticulum, fi stula, or combination of the above. Common indications for a staged urethroplasty included failed hypospadias surgery, multiple prior urethroplasty failures, and strictures associated with lichen sclerosus. Because excision and primary anastomosis has a signifi cant potential to produce postoperative chordee, staged procedures are more commonly used in the penile urethra relative to the bulbar urethra. Free tissue transfer is inherent to staged urethroplasties; common donor sources include buccal mucosa and split thickness skin. Preservation of the native urethral plate in selected cases allows maximization of donor graft with limited availability. A technical description of the staged urethroplasty is followed by a review of published success rates, which range from 73 to 100 %. Common complications of a staged repair include need for additional revisional surgery, fi stula, postoperative curvature, and recurrent stricture.

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Section: Modern Surgical Variations Of Staged Urethroplastymentioning

confidence: 99%