Changing practice in anterior urethroplasty.
OBJECTIVE
To describe our experience of penile urethral repair and reconstruction, cataloguing the change in practice from one-stage flap to two-stage free graft procedures for anterior urethroplasty.


METHODS
Between January 1992 and December 1996, 79 patients underwent anterior urethroplasty. Of the 45 one-stage bulbar patch urethroplasties, 37 (76%) used buccal mucosal free grafts rather than flaps. Of the 34 penile urethroplasties, 26 (82%) (including all of the circumferential reconstructions) were two-stage procedures.


RESULTS
Buccal mucosal free grafts were at least as good as local skin flaps for patch urethroplasty and two-stage repairs gave much better results than one-stage repairs for total circumferential reconstruction of the penile urethra.


CONCLUSIONS
For a patch urethroplasty of an uncomplicated stricture in the bulbar urethra, buccal mucosal free grafts are now the material of choice. For a patch urethroplasty of an uncomplicated stricture in the penile urethra the Orandi procedure remains the 'gold standard'. For a circumferential repair of the urethra, particularly the penile urethra, a two-stage repair using a free graft gives better results than a one-stage repair using a flap.
Greenwell
T J
TJ
Institute of Urology, London, UK.
Venn
S N
SN
Mundy
A R
AR
D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000601:surgery*; D011364:Professional Practice; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014522:Urethral Diseases / Q000601:surgery*