Year : 2017 | Volume
: 33 | Issue : 2 | Page : 155--158
A novel composite two-stage urethroplasty for complex penile strictures: A multicenter experience
Pankaj M Joshi1, Guido Barbagli2, Vikram Batra1, Sandesh Surana1, Atef Hamouda1, Salvatore Sansalone3, Dimitris Costi4, Massimo Lazzeri5, Craig Hunter1, Devang J Desai1, Fabio Castiglione1, Sanjay B Kulkarni1
1 Kulkarni Centre for Reconstructive Urology, Pune, Maharashtra, India
2 Department of Reconstructive Urology, Centro Chirurgico Toscano, Arezzo, Italy
3 Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy
4 Evangelistria Medical Centre, Nicosia, Cyprus
5 Humanitas Clinical and Researcher Centre, Humanitas University, Rozzano, Italy
Introduction: Complex penile strictures are usually repaired using a two-stage urethroplasty. Buccal mucosal graft (BMG) placed in the first stage can have a significant contraction rate, which may require a subsequent revision surgery. We describe a composite two-stage penile urethroplasty using BMG for patients of complex penile strictures who have some salvageable urethral plate.
Methods: Within a multi-institutional cohort, 82 patients underwent a two-stage urethroplasty for complex stricture of the penile urethra. Of these 42 patients who underwent our composite two-stage penile urethroplasty using BMG implanted at the second-stage were included. Patients with genital lichen sclerosus or incomplete clinical records were excluded from this study. The primary outcome of the study was to evaluate stricture-free success rate.
Results: Of total 42, 4 patients were lost to follow-up. 42% of stricture etiology was failed hypospadias repair. Mean stricture length was 4.5 cm (range 3–8 cm). Seventeen (44.7%) patients had undergone the previous urethroplasty. At a median follow-up of 44 months, of 38 patients, 34 (89.5%) were successful, and 4 (10.5%) had a recurrence. No patient required revision surgery before the second-stage and required redo buccal graft harvesting for subsequent urethroplasty.
Conclusions: The composite two-stage technique in repairing complex penile urethral strictures is a valid and reproducible surgical treatment for complex penile stricture and it may reduce the rate of contraction of the transplanted BMG.
Pankaj M Joshi
Kulkarni Centre for Reconstructive Urology, Pune, Maharashtra
|How to cite this article:|
Joshi PM, Barbagli G, Batra V, Surana S, Hamouda A, Sansalone S, Costi D, Lazzeri M, Hunter C, Desai DJ, Castiglione F, Kulkarni SB. A novel composite two-stage urethroplasty for complex penile strictures: A multicenter experience.Indian J Urol 2017;33:155-158
|How to cite this URL:|
Joshi PM, Barbagli G, Batra V, Surana S, Hamouda A, Sansalone S, Costi D, Lazzeri M, Hunter C, Desai DJ, Castiglione F, Kulkarni SB. A novel composite two-stage urethroplasty for complex penile strictures: A multicenter experience. Indian J Urol [serial online] 2017 [cited 2021 Sep 21 ];33:155-158
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2017;volume=33;issue=2;spage=155;epage=158;aulast=Joshi;type=0