Staged Urethroplasty for Penile Urethral Strictures From Lichen Sclerosus and Failed Hypospadias Repair.
Urology
; 112: 222-224, 2018 Feb.
Article
em En
| MEDLINE
| ID: mdl-29107132
ABSTRACT
OBJECTIVE:
To present our technique for staged urethroplasty with buccal mucosa graft.METHODS:
The patient presented is a 42-year-old man with a history of congenital hypospadias repaired as a child. He developed a penile urethral stricture at age 30 and was managed with self-intermittent dilation. Recently, dilation became more difficult, and he was referred for reconstruction. Workup revealed a high-grade stricture extending from the meatus to the site of the previous anastomosis at the penoscrotal junction. To contextualize the presented case, we performed a retrospective review of all staged penile urethroplasties performed at our institution from 2013 to 2016 (n = 20).RESULTS:
At 18 months' follow-up, the patient voids with an unobstructed, directable stream and has not required any urethral instrumentation. In our series, stricture etiology was lichen sclerosus in 9 (45%), failed hypospadias repair in 8 (40%), trauma in 2 (10%), and penile calciphylaxis in 1 (5%). At median follow-up of 520 days, 60% underwent second-stage urethroplasty at a median of 277 days after first-stage urethroplasty (range 213-738). No patients required grafting after first-stage surgery. Complications of second-stage surgery included wound dehiscence in 2 (17%), fistula in 1 (8%), and meatal stenosis in 1 (8%).CONCLUSION:
Staged penile urethroplasty is a safe and effective treatment option for patients with complex urethral strictures resulting from lichen sclerosus and failed hypospadias repair.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Uretra
/
Estreitamento Uretral
/
Líquen Escleroso e Atrófico
/
Hipospadia
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article