Use of Full Thickness Skin Grafts in Repair of Urethral Strictures

Devine, Patrick C.; Horton, Charles E.; Devine, Charles J.; Crawford, Hugh H.; Adamson, Jerome E.

doi:10.1016/s0022-5347(17)64362-3

Cited by 124 publications

(27 citation statements)

References 18 publications

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“…In 1963, Devine et al [53] were the first to introduce graft onlay urethroplasty using free pendulous skin for treatment of the urethral stricture. This method then became popular because of its simplicity and good results.…”

Section: Discussionmentioning

confidence: 99%

Dorsal Onlay versus Ventral Onlay Urethroplasty for Anterior Urethral Stricture: A Meta-Analysis

Wang¹,

Xunzhong²,

Wang

et al. 2009

Urol Int

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Background: Ventral and dorsal sides of urethra were chosen to place grafts in free graft onlay urethroplasty. As the advantages and disadvantages of these two sites are still unclear, we systemically analyzed clinical articles reported in the literature. Materials and Methods: The literature till October 2007 regarding the use of ventral/dorsal graft urethroplasty in anterior urethral strictures was searched using the MEDLINE, Cochrane Library, and EMBASE databases. ‘Urethral stricture’ or ‘urethral stenosis’ and ‘urethroplasty’ or ‘urethral reconstruction’ were used as search terms. Data were analyzed independently by two reviewers. Results: 49 studies (1,263 cases) were included. The success rates of ventral onlay urethroplasty (750 cases) and dorsal onlay (513 cases) were 82.5 and 86.9% (p = 0.034). Buccal mucosa graft had the highest success rate (88.1%) and had a similar rate between the dorsal and ventral onlay techniques (89.2 vs. 87.6%, p = 0.472). For free skin graft, the dorsal onlay success rate was higher than ventral (84.7 vs. 74.7, p = 0.016). Bulbar urethral stricture achieved the higher success rate than pendulous urethral stricture (87.4 vs. 77.6%, p = 0.019). Conclusions: Dorsal onlay is better than ventral onlay in free skin graft urethroplasty. Bulbar urethra is the most suitable site for graft onlay urethroplasty, and buccal mucosa graft is helpful for achieving good results.

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Section: Discussionmentioning

confidence: 99%

Dorsal Onlay versus Ventral Onlay Urethroplasty for Anterior Urethral Stricture: A Meta-Analysis

Wang¹,

Xunzhong²,

Wang

et al. 2009

Urol Int

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“…In 1961, Devine and Horton fully described the use of preputial skin to repair hypospadias using a one-stage technique (18). In 1963, Devine et al, after successfully using preputial skin in onestage hypospadias repair, popularized the use of the free skin graft in the repair of urethral strictures (19). From 1973 to 1985, beginning with these preliminary studies, several authors reported the use of preputial skin grafts in urethral reconstruction, suggesting a range of different surgical techniques (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

Section: Substitute Material: Oral Mucosa Vs Skinmentioning

confidence: 99%

Current controversies in reconstructive surgery of the anterior urethra: a clinical overview

Barbagli

Sansalone

Djinovic³

et al. 2012

Int. braz j urol.

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“…Although generally a one-stage urethroplasty is prefer able [1], many complicated urethral strictures demand a two-stage procedure because of severe tissue defects sec ondary to scaring, infection or multiple operations [2,3], In these patients healthy, smooth tissue must be provided to start a successful urethral reconstruction [4], Methods which use scrotal skin for this first stage all suffer from a high rate of stricture recurrence of the reconstructed ure thra [5], The majority of failures are secondary to hair growth in the urethra, causing subsequent infection and stone formation. Furthermore scrotal skin is temperature sensitive, which may cause wide, ballooned urethras lead ing to the formation of diverticula.…”

Section: Introductionmentioning

confidence: 99%

“…The surface of scrotal skin is not smooth secondary to the aforementioned effect and the hair follicles, which caused a remarkable resis tance for the process of ejaculation. All these difficulties do not occur with urethroplasties using full-thickness foreskin, as a free transplant [4], If meshed, wound drain age is significantly better and the healing pattern even better. These circumstance directed us to meshgraft ure throplasty with foreskin, which reduces the rate of post operative stricture formation significantly [6,7], In cir cumcized patients or in cases where the amount of fore skin does not fit the wound area, the use of a split-thick ness skin graft was the other logical step.…”

Section: Introductionmentioning

confidence: 99%

Meshgraft Urethroplasty Using Split-Thickness Skin Graft

Noll¹,

Schreiter²

1990

Urol Int

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Meshgraft urethroplasty has become one of the standard operative procedures for the treatment of long and complicated urethral strictures. The original method used meshed foreskin for urethral reconstruction. To extend the application of the method to circumcized patients, a split-thickness skin graft was used to construct a neo-urethra. In a first stage, a split thickness skin graft is harvested from the medical part of the thigh and transplanted alongside the opened urethra. After complete healing of this transplant, the neo-urethra is formed in a second stage 12 weeks later. Since 1980 meshgraft urethroplasty using a split-thickness skin graft has been performed in 34 patients. In all patients excellent anatomic and functional results have been achieved. This technique was found to be most useful in exceedingly long or problematic strictures, e.g. in spinal cord-injured patients.

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Use of Full Thickness Skin Grafts in Repair of Urethral Strictures

Cited by 124 publications

References 18 publications

Dorsal Onlay versus Ventral Onlay Urethroplasty for Anterior Urethral Stricture: A Meta-Analysis

Dorsal Onlay versus Ventral Onlay Urethroplasty for Anterior Urethral Stricture: A Meta-Analysis

Current controversies in reconstructive surgery of the anterior urethra: a clinical overview

Meshgraft Urethroplasty Using Split-Thickness Skin Graft

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