Q‐flap reconstruction of panurethral strictures

Abstract

Objective To review our experience with an extended Qshaped penile skin¯ap for the reconstruction of panurethral strictures. Patients and methods Between 1991 and 1999, 15 men with extensive strictures underwent a single-stage urethral reconstruction with a distal circumferential penile skin¯ap incorporating a ventral midline extension (Q-¯ap). None had undergone previous urethroplasty nor had any been circumcised. Results The Q-¯ap provided a pedicled strip of penile skin with a mean (range) length of 17 (15±24) cm; no additional graft materials were necessary. Excellent results were obtained in 10 patients; in the remainder, complications included recurrent stricture (in two) and (in one patient each) a cerebral vascular accident, urethrocutaneous ®stula, meatal stenosis, femoral neuropathy and prolonged catheterization for focal extravasation. Conclusion The Q-¯ap provides an abundant hairless penile skin¯ap that enables single-stage panurethral reconstruction while eliminating the additional time and morbidity of harvesting further grafts.

Management of Panurethral Stricture Disease in India

“…11 Another approach uses a fasciocuta- neous skin flap and has several avatars with incision modifications or simultaneous use of a buccal mucosa graft. [12][13][14][15][16][17] Repair with tunica albuginea was also suggested. 18 Dubey et al compared their experience with 1-stage repair using our technique and 2-stage repair for LS strictures.…”

Urethral stricture Yemen experience

“…El-Kassaby et al reported excellent results in 90% of cases upon the use of buccal mucosal grafts harvested from the lower lip in management of anterior urethral stricture [7]. Non-hirsute penile fasciocutaneous flaps constitute the most durable substitution technique for pendulous stricture disease, with long-term studies reporting 90-96% success [27]. Our experience with buccal mucosal graft urethroplasty was limited for high success we got, therefore the result to be accepted, it needs more cases.…”

Single-Staged Improved Tubularized Preputial/Penile Skin Flap Urethroplasty for Obliterated Anterior Urethral Stricture: Long-Term Results

“…2a-d). PSFs were developed using the detailed techniques described previously [4,8]. After splitting the flap ventrally, the pedicle was mobilized proximally to an extent that allows ventral transposition of the flap without tension.…”

“…McAninch [3] reported using the circular fasciocutaneous penile flap to treat AUS, and they summed up the experience of 66 cases in 1998 and obtained satisfactory outcome. Morey et al [4] reported an extended Q-shaped PSF for the reconstruction of panurethral strictures. Most authors have reported similar success rates of 83-93% for both the free grafts and pedicled skin flaps, but generally poorer results with the formation of a tube [5,6].…”