A R Mundy1. 1. Department of Urology, Guy's Hospital, London, UK.
Abstract
OBJECTIVE: To report the results of a 10-year follow-up of 73 patients who underwent skin-inlay urethroplasty for the treatment of strictures that failed to respond to a trial of endoscopic surgery. PATIENTS AND METHODS: The 10 year follow-up of 48 patients with patch urethroplasties and 25 with tube urethroplasties of pedicled preputial, penile and scrotal skin is reported. RESULTS: The patients with patch urethroplasties tended to do well in the medium term whatever the source of skin, although there was a steady annual attrition rate after 4 years of about 5%/year requiring revision. The 25 patients with tube urethroplasties did less well, particularly those with scrotal skin tubes. The patients with preputial/penile tube urethroplasties did rather better but, in general, all these tube urethroplasties seem to narrow uniformly with time. Urethrotomy was never curative when a stricture recurred in relation to a urethroplasty. CONCLUSION: If the initial result is satisfactory, then patch urethroplasties tend to do well in the medium term whatever the source of the flap. No matter how good the initial result, scrotal skin tube urethroplasties do badly; preputial/penile skin performs better but tube urethroplasties tend to narrow down nonetheless. In the long term--more than 10 years--all skin inlays seem to have a tendency to deteriorate.
OBJECTIVE: To report the results of a 10-year follow-up of 73 patients who underwent skin-inlay urethroplasty for the treatment of strictures that failed to respond to a trial of endoscopic surgery. PATIENTS AND METHODS: The 10 year follow-up of 48 patients with patch urethroplasties and 25 with tube urethroplasties of pedicled preputial, penile and scrotal skin is reported. RESULTS: The patients with patch urethroplasties tended to do well in the medium term whatever the source of skin, although there was a steady annual attrition rate after 4 years of about 5%/year requiring revision. The 25 patients with tube urethroplasties did less well, particularly those with scrotal skin tubes. The patients with preputial/penile tube urethroplasties did rather better but, in general, all these tube urethroplasties seem to narrow uniformly with time. Urethrotomy was never curative when a stricture recurred in relation to a urethroplasty. CONCLUSION: If the initial result is satisfactory, then patch urethroplasties tend to do well in the medium term whatever the source of the flap. No matter how good the initial result, scrotal skin tube urethroplasties do badly; preputial/penile skin performs better but tube urethroplasties tend to narrow down nonetheless. In the long term--more than 10 years--all skin inlays seem to have a tendency to deteriorate.