Free Full Thickness Skin Graft Urethroplasty: Current Technique

Devine, Patrick C.; Wendelken, James R.; Devine, Charles J.

doi:10.1016/s0022-5347(17)56754-3

Cited by 40 publications

(9 citation statements)

References 6 publications

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“…Urethroplasty has undergone major development over the years. The first graft to be used in urethral reconstruction was the preputial graft described by Devine et al 5 Dorsal-onlay urethroplasty is a standard technique nowadays for long bulbar urethral stricture most commonly utilizing buccal mucosa with a high success rate. 6 Urology has always been at the forefront for the use of new technological development.…”

Section: Discussionmentioning

confidence: 99%

Robotic Dorsal-Onlay Urethroplasty: A Case Report

Alwaal¹,

Jensen²

2018

WVMJ

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Urethroplasty is considered the gold standard treatment for urethral stricture disease with over 90% success rate. Dorsal-onlay urethroplasty using buccal or skin grafts is a crucial technique for managing long anterior strictures. We report here the feasibility of performing robotic dorsal-onlay urethroplasty utilizing preputial graft. A 63-year-old man was referred for radical prostatectomy. Initial retrograde urethrogram showed urethral stricture within the membranous portion of the urethra extending into the bulbar urethra. Plan of conservative management of the prostate cancer, in addition to robotic urethroplasty utilizing a dorsal-onlay preputial skin graft. A preputial graft was harvested and placed dorsally into the bulbomembranous urethra using the Da Vinci Si system. Operative time was 2 hours, and postoperative course was uneventful. After 7.5-year follow-up, the patient remained asymptomatic and no evidence of stricture recurrence on cystoscopy. The patient did not require any intervention for either his stricture disease or prostate cancer, which did not progress on follow-up MR-US Fusion biopsies. Robotic dorsal-onlay urethroplasty is feasible and can be performed without prolonging the length of the surgery. Future directions should focus on performing this surgery using smaller incisions. Case Report | WVMJ OA

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Section: Discussionmentioning

confidence: 99%

Robotic Dorsal-Onlay Urethroplasty: A Case Report

Alwaal¹,

Jensen²

2018

WVMJ

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“…The dorsal approach allows dorsal grafting; in 1979 Devine et al [9] popularised the use of free-skin graft techniques in anterior urethral reconstruction. In 1980, Monseur [10] first described a new type of urethroplasty that involved opening of the urethra along its dorsal surface and fixing the opened urethra over the corpora cavernosa, thus allowing the regeneration of the urethral mucosa by leaving a catheter in situ for a long time.…”

Section: Grafting By the Dorsal Approachmentioning

confidence: 99%

The advantages of the ventral approach to bulbar urethroplasty

Palminteri

Berdondini

Pierro

2013

Arab Journal of Urology

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BackgroundSeveral surgical techniques have been described for the treatment of bulbar urethral strictures, and the main goal of modern surgery is to reduce morbidity and obtain the best outcome with the fewest complications. Currently, the superiority of one surgical technique over another has not yet been clearly defined.MethodsWe analysed the historical background, advantages and disadvantages of several urethral approaches and graft placements, with the aim of focusing on the advantages of the ventral approach.ConclusionsFor short bulbar strictures (<2 cm) the traditionally advocated method is excision and end-to-end anastomosis, whilst for longer strictures, in the last decade, the patch graft urethroplasty has been used, with buccal mucosa advocated as the standard material of substitution. Our analysis showed that the approach (dorsal vs. ventral) to the bulbar urethral lumen and the location of the patch (dorsal vs. ventral) are contentious issues. Overall, surgeons tend to use techniques that are easy, quick and give excellent outcomes with few complications. The graft urethroplasty using the ventral approach fulfils these requirements.

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“…In 1979, Devine et al . [4] popularised the use of free‐skin graft techniques in anterior urethral reconstruction. In 1980, Monseur [5] first described a new urethroplasty, opening the urethra along its dorsal surface and fixing the opened urethra over the corpora cavernosa, thus regeneration of the urethral mucosa is obtained by leaving a catheter in place for a long period.…”

Section: Introductionmentioning

confidence: 99%