Dmitriy Nikolavsky1, Mourad Abouelleil2, Michael Daneshvar2. 1. Department of Urology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA. Nikolavd@upstate.edu. 2. Department of Urology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA.
Abstract
OBJECTIVES: To introduce a novel surgical technique for the reconstruction of distal urethral strictures using buccal mucosal graft (BMG) through a transurethral approach. METHODS: A retrospective institution chart review was conducted of all the patients who underwent a transurethral ventral BMG inlay urethroplasty from March 2014 to March 2016. Patients with greater than one-year follow-up were included. Steps of the procedure: transurethral ventral wedge resection of the stenosed segment and transurethral delivery and spread fixation of appropriate BMG inlay into the resultant urethrotomy. The patients were followed for post-operative complications and stricture recurrence with uroflow, PVR, cystoscopy and outcome questionnaires. RESULTS: Three patients with a minimum of 12-month follow-up are included in this case series. The mean age of the patients was 42 years (35-53); mean stricture length was 2.1 cm (1-4). All patients had at least 2 previous failed procedures. Mean follow-up was 18 months (12-24). There were no stricture recurrences or fistula. Mean pre- and post-operative uroflow values were 4.3 (0-8) and 19 (16-26), respectively. Neither penile chordee nor changes in sexual function were noted in patients on follow-up. CONCLUSION: Transurethral ventral BMG inlay urethroplasty is a feasible option for treatment of fossa navicularis strictures. This single-stage technique allows for avoiding skin incision or urethral mobilization. It helps to prevent glans dehiscence, fistula formation and avoids the use of genital skin flaps in all patients, especially those affected with LS. This novel surgical technique is an effective treatment alternative for men with distal urethral strictures.
OBJECTIVES: To introduce a novel surgical technique for the reconstruction of distal urethral strictures using buccal mucosal graft (BMG) through a transurethral approach. METHODS: A retrospective institution chart review was conducted of all the patients who underwent a transurethral ventral BMG inlay urethroplasty from March 2014 to March 2016. Patients with greater than one-year follow-up were included. Steps of the procedure: transurethral ventral wedge resection of the stenosed segment and transurethral delivery and spread fixation of appropriate BMG inlay into the resultant urethrotomy. The patients were followed for post-operative complications and stricture recurrence with uroflow, PVR, cystoscopy and outcome questionnaires. RESULTS: Three patients with a minimum of 12-month follow-up are included in this case series. The mean age of the patients was 42 years (35-53); mean stricture length was 2.1 cm (1-4). All patients had at least 2 previous failed procedures. Mean follow-up was 18 months (12-24). There were no stricture recurrences or fistula. Mean pre- and post-operative uroflow values were 4.3 (0-8) and 19 (16-26), respectively. Neither penile chordee nor changes in sexual function were noted in patients on follow-up. CONCLUSION: Transurethral ventral BMG inlay urethroplasty is a feasible option for treatment of fossa navicularis strictures. This single-stage technique allows for avoiding skin incision or urethral mobilization. It helps to prevent glans dehiscence, fistula formation and avoids the use of genital skin flaps in all patients, especially those affected with LS. This novel surgical technique is an effective treatment alternative for men with distal urethral strictures.
Authors: Michael Daneshvar; Jay Simhan; Stephen Blakely; Javier C Angulo; Jacob Lucas; Craig Hunter; Justin Chee; Damian Lopez Alvarado; Erick Alejandro Ramirez Perez; Alosh Madala; Juan José de Benito; Francisco Martins; João Felício; Paul Rusilko; Brian J Flynn; Dmitriy Nikolavsky Journal: World J Urol Date: 2020-01-01 Impact factor: 4.226
Authors: Felix Campos-Juanatey; Simon Bugeja; Mariya Dragova; Anastasia V Frost; Stella L Ivaz; Daniela E Andrich; Anthony R Mundy Journal: Asian J Androl Date: 2020 Mar-Apr Impact factor: 3.285