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Urology Aprile 2016

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Kulkarni Dorsolateral Graft Urethroplasty Using Penile Skin

Enzo Palminteri, Elisa Berdondini, Nicolaas Lumen, Serena Maruccia, Mirko Florio, Giorgio Franco, Vittorino Montanaro, and Giovanni Battista Di Pierro

Objectives:

To investigate the safety, efficacy, and versatility of dorsolateral graft urethroplasty using penile skin.

Materials and Methods:

Between 2010 and 2013, 37 men with anterior urethral strictures underwent dorsolateral graft urethroplasty using penile skin by a single surgeon (EP). Inclusion criterion was patients with anteriorurethralstrictures.Exclusioncriteriawerelichensclerosus-relatedstrictures,absenceofavailable penile skin because of previous surgery, and obliterative urethral strictures. Clinical outcome wasconsideredafailurewhenanypostoperativeinstrumentationwasneeded,includingdilatation.

Results:

Mean (± standard deviation) patients age was 51 (±15.4) years. Stricture etiology was iatrogenic in 25 cases (67%), unknown in 10 (27%), trauma in 2 (6%). Stricture site was penile in 21 (57%) and peno-bulbar in 16 (43%). Median (range) stricture length was 5 cm (1-15). Of 37 patients, 30 (81%) had received previous treatments. Median (range) follow-up was 21 months (12-47). Of 37 patients, 34 (92%) had successful treatment and 3 (8%) had failed treatment. The 3 patients with failed treatment were treated with urethrostomy and are awaiting further reconstruction. Study limitations include the small sample size and the limited follow-up.

Conclusions:

With a mid-term follow-up time, the dorsolateral graft urethroplasty using penile skin is shown to be a safe, efficient, and versatile technique for the repair of short-mid-long anterior urethral strictures. UROLOGY 90: 179–183, 2016. © 2016 Elsevier Inc.

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