Eric J Hick1, Allen F Morey. 1. Urology Service, Brooke Army Medical Center, San Antonio, Texas, USA.
Abstract
PURPOSE: We assessed whether fibrin sealant promotes early catheter removal after pendulous urethral reconstruction. MATERIALS AND METHODS: Between 1997 and 2003, 43 men with complex stricture disease underwent pendulous urethral reconstruction by a single surgeon (AFM). In 18 consecutive cases with a mean stricture length of 7.24 cm from 2000 to 2003 fibrin sealant was applied over a ventral onlay anastomosis performed with running 5-zero polydiaxanone suture. Results were compared with those in 25 men who underwent the procedure without fibrin sealant from 1997 to 2000, who served as a control group (mean stricture length 8.30 cm, p = 0.418). Catheter duration was recorded after anastomosis integrity was radiographically confirmed. RESULTS: All 18 patients with sealant were completely healed within 14 days, which was significantly shorter than in controls (p <0.001). In the sealant group increased stricture length was associated with longer catheter time (p = 0.677). Our impressions were that patient satisfaction was enhanced by early catheter removal, and postoperative penile edema and ecchymosis were decreased in the fibrin sealant group. CONCLUSIONS: Fibrin sealant appears to promote early catheter removal and enhanced wound healing after pendulous urethral reconstruction.
PURPOSE: We assessed whether fibrin sealant promotes early catheter removal after pendulous urethral reconstruction. MATERIALS AND METHODS: Between 1997 and 2003, 43 men with complex stricture disease underwent pendulous urethral reconstruction by a single surgeon (AFM). In 18 consecutive cases with a mean stricture length of 7.24 cm from 2000 to 2003 fibrin sealant was applied over a ventral onlay anastomosis performed with running 5-zero polydiaxanone suture. Results were compared with those in 25 men who underwent the procedure without fibrin sealant from 1997 to 2000, who served as a control group (mean stricture length 8.30 cm, p = 0.418). Catheter duration was recorded after anastomosis integrity was radiographically confirmed. RESULTS: All 18 patients with sealant were completely healed within 14 days, which was significantly shorter than in controls (p <0.001). In the sealant group increased stricture length was associated with longer catheter time (p = 0.677). Our impressions were that patient satisfaction was enhanced by early catheter removal, and postoperative penile edema and ecchymosis were decreased in the fibrin sealant group. CONCLUSIONS: Fibrin sealant appears to promote early catheter removal and enhanced wound healing after pendulous urethral reconstruction.
Authors: Sashi S Kommu; Robert McArthur; Amr M Emara; Utsav D Reddy; Christopher J Anderson; Neil J Barber; Raj A Persad; Christopher G Eden Journal: Rev Urol Date: 2015