Investig Clin Urol.  2016 Mar;57(2):135-140. 10.4111/icu.2016.57.2.135.

Penile inversion through a penoscrotal incision for the treatment of penile urethral strictures

• Warner JN
• Tracey JM
• Zhumkhawala AA
• Chan KG
• Lau CS

• KMID: 2363136
• DOI: http://doi.org/10.4111/icu.2016.57.2.135

Abstract

PURPOSE
This article describes a novel technique for the repair of penile urethral strictures and establishes the safety, feasibility, and efficacy of this innovative surgical approach.
MATERIALS AND METHODS
Patients with urethral strictures underwent a one-sided anterior dorsal oral mucosal graft urethroplasty through a penoscrotal inversion technique. The clinical outcome was considered a failure when any instrumentation was needed postoperatively, including dilatation.
RESULTS
Five patients underwent the novel procedure. The patients' mean age was 58 years. The cause of stricture was instrumentation in 2 cases (40%), lichen sclerosis in 1 case (20%), and failed hypospadias repair in 2 cases (40%). The mean stricture length was 3 cm. The overall mean (range) follow-up was 6 months (range, 3-9 months). Of the 5 patients, 4 (80%) had a successful outcome and 1 (20%) had a failed outcome. The failure was successfully treated by use of a meatotomy.
CONCLUSIONS
The penile inversion technique through a penoscrotal incision is a viable option for the management of penile urethral strictures with several advantages to other techniques: namely, no penile skin incision, a single-stage operation, and supine positioning.

Keyword

Mouth mucosa; Surgery; Urethral stricture

MeSH Terms

Aged
Feasibility Studies
Humans
Male
Middle Aged
Mouth Mucosa/transplantation
Patient Positioning
Penis/*surgery
Postoperative Care
Preoperative Care/methods
Scrotum/*surgery
Treatment Outcome
Urethral Stricture/*surgery

Figure

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  Fig. 1 Penoscrotal incision.

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  Fig. 2 The penis is inverted.

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  Fig. 3 The urethra is dissected off the corpora.

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  Fig. 4 The glans is incised dorsally.

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  Fig. 5 The urethrotomy is extended to the penile urethra.

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  Fig. 6 The graft is quilted to the glans.

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  Fig. 7 The graft is quilted down to the corpora.

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  Fig. 8 Surgical glue placed under the graft.

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  Fig. 9 Surgical glue applied to the penile skin.

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  Fig. 10 The incision is closed.

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