One-stage transverse distal penile/preputial island flap urethroplasty for urethral stricture.
The rich blood supply of the penis, derived from three longitudinal arterial and venous pedicles and numerous transvesical anastomoses allows the raising of a full thickness skin graft obliquely underneath the glans and around the penis. An island flap, which can be as long as 15 cm, is isolated but its blood supply is preserved by cleaving the connective tissue underneath the basic flap. The vascularised island flap is then rotated towards the zone of urethral replacement either in the form of a flap or a tube which can extend as far as the membranous urethra. 150 cases have been operated with this pedicle flap as a one-stage operation. No cases of necrosis were observed, even in the presence of fistulae or periurethral abscesses. A post-operative proximal stricture was observed in 10% of cases and was treated by internal urethrotomy. One third of these failures had to be reoperated with no major difficulties. Two pre-existing urethrocutaneous fistulae also had to be reoperated.
Quartey
J K
JK
University of Ghana Medical School, Accra.
D006801:Humans; D008297:Male; D010413:Penis / Q000098:blood supply; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods* / Q000473:pathology; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods* / Q000473:pathology; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*