Guido Barbagli1, Graziella Pellegrini2, Francesca Corradini2, Francesco Montorsi3, Salvatore Sansalone4, Denis Butnaru5, Massimo Lazzeri6. 1. Centro Chirurgico Toscano, Arezzo, Italy. 2. Centre for Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. 3. Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy. 4. Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy. 5. Research Institute for Uronephrology, Sechenov First Moscow State Medical University, Moscow, Russia. 6. Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, Italy. Electronic address: massimo.lazzeri@humanitas.it.
Abstract
BACKGROUND: Repair of penile urethral strictures is a challenging problem for which different techniques have been suggested. OBJECTIVE: To describe a new surgical technique for one-stage penile urethroplasty using an oral graft and glue, and to assess its safety and efficacy. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of medical records for patients who underwent one-stage penile urethroplasty using oral mucosa and glue from February 2013 to October 2014 was performed. SURGICAL PROCEDURE: The penile urethra was opened and the urethral plate was incised to create a wide window within which the oral graft was pasted with glue. The urethra was sutured over the catheter. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Clinical data were collected in a database. Intraoperative and postoperative complications and outcomes were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: Fourteen patients were included in the study. Median operative time was 60min. The median postoperative stay was 3 d. Three intraoperative and one postoperative complication occurred. In all patients, voiding cystourethrography 2 wk after surgery failed to show urethral fistula or sacculation. No patients complained of penile chordee or sexual dysfunction after surgery. Median follow-up was 16 mo. Among the 14 patients, 12 (85.7%) procedures were successful and two (14.3%) were failures. Study limitations include the small sample size and short follow-up. CONCLUSIONS: An in vitro study and a one-stage reconstruction of penile urethral strictures with an oral mucosa graft and glue showed that the procedure is safe and efficient, but further studies including larger series of patients and longer follow-up are required. PATIENT SUMMARY: We report on the repair of penile urethral stricture using one-stage urethroplasty with oral mucosa and glue. This new technique was safe and effective, with limited complications and satisfactory outcomes. We plan to increase the use of this technique in the future.
BACKGROUND: Repair of penile urethral strictures is a challenging problem for which different techniques have been suggested. OBJECTIVE: To describe a new surgical technique for one-stage penile urethroplasty using an oral graft and glue, and to assess its safety and efficacy. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of medical records for patients who underwent one-stage penile urethroplasty using oral mucosa and glue from February 2013 to October 2014 was performed. SURGICAL PROCEDURE: The penile urethra was opened and the urethral plate was incised to create a wide window within which the oral graft was pasted with glue. The urethra was sutured over the catheter. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Clinical data were collected in a database. Intraoperative and postoperative complications and outcomes were assessed. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: Fourteen patients were included in the study. Median operative time was 60min. The median postoperative stay was 3 d. Three intraoperative and one postoperative complication occurred. In all patients, voiding cystourethrography 2 wk after surgery failed to show urethral fistula or sacculation. No patients complained of penile chordee or sexual dysfunction after surgery. Median follow-up was 16 mo. Among the 14 patients, 12 (85.7%) procedures were successful and two (14.3%) were failures. Study limitations include the small sample size and short follow-up. CONCLUSIONS: An in vitro study and a one-stage reconstruction of penile urethral strictures with an oral mucosa graft and glue showed that the procedure is safe and efficient, but further studies including larger series of patients and longer follow-up are required. PATIENT SUMMARY: We report on the repair of penile urethral stricture using one-stage urethroplasty with oral mucosa and glue. This new technique was safe and effective, with limited complications and satisfactory outcomes. We plan to increase the use of this technique in the future.