Substitution Urethroplasty of Complex and Long-Segment Urethral Strictures: A Rationale for Procedure Selection

Xu, Yuhong; Ye, Qiao; Yang, Sa; Wu, D.; Zhang, Xinru; Jion, Zhang; Gu, Baojun; Jin, San-Bao

doi:10.1016/j.eururo.2006.11.039

Cited by 50 publications

(28 citation statements)

References 18 publications

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“…The substitution materials have changed from the pedicled skin flaps to grafts [1,2,3,4,5,15,16,17]. The pedicled skin flaps of the prepuce or scrotum can survive easily due to good blood supply.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of complex urethral stricture remains one of the most challenging problems for urologists although a lot of methods have been reported [1,2,3,4,5]. Although the overall success rate is 76.9-85.7%, there are always a lot of complications and problems [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Although the overall success rate is 76.9-85.7%, there are always a lot of complications and problems [3,4,5]. Reconstruction of the urethra in patients suffering from aphallia is an even more challenging problem [6].…”

Section: Introductionmentioning

confidence: 99%

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Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

Liu

et al. 2012

Urol Int

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Objective: To determine the feasibility and effectivity of allogenic frozen-thawed bladder mucosa for urethroplasty. Methods: Bladder mucosa was harvested from 6 New Zealand rabbits. Changes in the bladder mucosa as seen by histological and electron microscope examination were compared between the frozen-thawed and fresh groups. Twelve urethral stricture models were established and randomly divided into two groups. In the test group, we performed urethroplasty with allogenic frozen-thawed bladder mucosa, and the same operation was done in the control group, but using fresh bladder mucosa. The result of retrograde urethrography and histological changes of the urethral sample were compared postoperatively. Results: No obvious changes on histological and electron microscope examination were observed in the frozen-thawed bladder mucosa. Inflammation reaction of the surgical site in the test group was milder than that of the controls 2 weeks after surgery. The urethral epithelial cells grew well 2 weeks after surgery, but lots of epithelia were necrotic in the control group. The urethra of all rabbits in the test group had good continuity and the urethral lumen was large in the test group 2 months after surgery. There was a layer of urethral epithelium in the test group 2 months after surgery, whereas scar tissue was found in the control group. Conclusions: The freeze-thaw technique can maintain bladder mucosa structure and biological function. Frozen-thawed allogenic bladder mucosa may be a potential material for urethroplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

Liu

et al. 2012

Urol Int

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“…Such strictures were traditionally managed with 2-stage repairs using scrotal skin (1,2). However, as the field of urethral reconstruction developed, there was a move towards 1-stage repair using free grafts made of skin, pedicle-based flaps or combined approaches (3)(4)(5)(6)(7)(8)(9). Numerous substitution urethroplasty techniques have been described and there were, however, no universally accepted graft material for either primary urethral substitution or technique of reconstruction after multiple failed attempts.…”

Section: Introductionmentioning

confidence: 99%

“…Numerous substitution urethroplasty techniques have been described and there were, however, no universally accepted graft material for either primary urethral substitution or technique of reconstruction after multiple failed attempts. (3)(4)(5)(6)(7)(8)(9). The penile skin flap provided a versatile mechanism for achieving excellent results in the single-stage repair of complex anterior urethral strictures.…”

Section: Introductionmentioning

confidence: 99%

The Treatment of Panurethral Strictures

Xu¹,

Cao²

2011

Current Concepts of Urethroplasty

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Anterior substitutional urethroplasty using a biomimetic poly‐l‐lactide nanofiber membrane: Preclinical and clinical outcomes

Song

Deng²,

Yuan

et al. 2022

Bioengineering & Transla Med

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The aim of this study is to investigate the feasibility and efficacy of a novel biomimetic poly‐l‐lactide (PLLA) nanofiber membrane in repairing anterior urethral strictures from both preclinic and clinic. Biomimetic PLLA membrane was fabricated layer by layer according to the structure of human extracellular matrix. Microstructure, tensile strength, and suture retention strength were fully assessed. Before the clinical application, the safety and toxicology test of the biomimetic PLLA membrane was performed in vitro and in experimental animals. The patients underwent urethroplasty used dorsal onlay or lateral onlay technique. Then, they were followed up for 1 month, 3 months, 6 months, and then annually after the surgery. The mechanical experiments showed well property for application. Biomimetic PLLA membrane was safe according to the in vitro and animal studies. Then, a total of 25 patients (mean age 48.96 years) were included in the study from September 2016 to December 2018. After a mean follow‐up of 33.56 months, 20 patients successfully treated with biomimetic PLLA membrane. Five patients (2 bulbar and 3 penile) suffered postoperational urethral stricture recurrence. None of infection or urinary fistula or any other adverse events related to the use of biomimetic PLLA membrane were observed during the follow‐up period for all patients. The preliminary result confirmed the feasibility and efficacy of the biomimetic PLLA membrane as a novel material for anterior urethral repair. The long‐term effects with more patients should be investigated in further studies.

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Substitution Urethroplasty of Complex and Long-Segment Urethral Strictures: A Rationale for Procedure Selection

Cited by 50 publications

References 18 publications

Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

The Treatment of Panurethral Strictures

Anterior substitutional urethroplasty using a biomimetic poly‐l‐lactide nanofiber membrane: Preclinical and clinical outcomes

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