World J Mens Health.  2014 Aug;32(2):87-92. 10.5534/wjmh.2014.32.2.87.

Surgical Outcome of Urethroplasty Using Penile Circular Fasciocutaneous Flap for Anterior Urethral Stricture

• Kim KR
• Suh JG
• Paick JS
• Kim SW

• KMID: 2320798
• DOI: http://doi.org/10.5534/wjmh.2014.32.2.87

Abstract

PURPOSE
Penile circular fasciocutaneous flap urethroplasty is a useful technique for a long anterior urethral stricture due to the flap's hairless nature and ample length. We investigated the surgical outcomes of urethroplasty for a complex anterior urethral stricture, performed using a penile circular fasciocutaneous flap.
MATERIALS AND METHODS
Between 2008 and 2013, we performed a retrospective review of 29 patients who underwent urethroplasty using a penile circular fasciocutaneous flap and had at least 6 months of follow-up. A total of 20 cases utilized only a fasciocutaneous flap, while 9 cases combined a fasciocutaneous flap with other surgery. Success was defined as no requirement of additional urethral instrumentation.
RESULTS
The overall success rate was 68.9% (20 out of 29 cases) at a median follow-up of 19 months. Furthermore, fasciocutaneous flap urethroplasty rendered the actual stricture-free rate of 79.3%. The location of recurrence was mostly at the junction of the flap. Among 9 surgical failures, 5 cases were treated successfully by using an additional surgical procedure. Fistula repair was needed in 1 case 4 months later. Further, periodic urethral dilation was performed in the remaining 3 cases. The failure rate was significantly higher in patients with suprapubic cystostomy than in patients without suprapubic cystostomy. The most common complication was post-micturition dribbling.
CONCLUSIONS
Penile circular fasciocutaneous flap urethroplasty is a useful method for the reconstruction of a long anterior urethral stricture. A sufficient healthy margin should be acquired for better surgical results due to the fact that most recurrence occurs at the junction of the flap.

Keyword

Penis; Surgical flaps; Urethral stricture

MeSH Terms

Cystostomy
Fistula
Follow-Up Studies
Humans
Male
Penis
Recurrence
Retrospective Studies
Surgical Flaps
Urethral Stricture*

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