[Local anesthesia in meatoplasty with pediculated flap, an efficient technique in the treatment of meatal stenosis].
Meatal stricture is not an uncommon condition in the clinical practice, the classical treatment being meatotomy. The failure of the technique and the changes in the quality of the urinary stream have forced us to perform a meatoplasty procedure with pedicle flap from penial skin as described by Jordan, using intravenous local anaesthetics, thus avoiding hospitalization and reducing the overall cost of the procedure. From a total of 23 patients who (between May 1995 and April 1998) required surgery due to meatal stricture, 11 patients underwent meatoplasty and the rest meatotomy. None of the patients in the former group developed re-stenosis, and achieved a mean improvement of Q max in the flowmetry performed three months after the procedure of 23 mL/sg. vs the 10.5 mL/sg. of patients undergoing meatotomy. This difference is statistically significant at p = 0.02. Cost saving when surgery is conducted in the day hospital is 122,302 pts/procedure vs 215,182 pts/procedure if the patient had to remain in hospital for 3 or 7 days. Compared to the lower cost of meatotomy (39,308 pts/proc.) or meatoplasty (57,525 pts/proc.), it must be emphasised that the management of complications in the first case is 6,816 pts/patient vs 1,724 pts/patient required for cures in the case of Jordan's technique. It was concluded that pedicle flap meatoplasty is an efficient and definitive technique in the treatment of meatal stricture.
D000368:Aged; D000772:Anesthesia, Local; D003365:Costs and Cost Analysis; D006801:Humans; D008875:Middle Aged; D013524:Surgical Flaps; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000191:economics / Q000379:methods*