Urethral plate salvage with dorsal graft promotes successful penile flap onlay reconstruction of severe pendulous strictures.
OBJECTIVE
A modified 1-stage penile flap onlay reconstruction is presented for patients with a long stricture in whom the urethral plate is deficient or absent.


METHODS
Of 37 patients who underwent transverse penile island flap onlay urethroplasty 3 men and 1 boy required simultaneous augmentation (2) or replacement (2) of an inadequate urethral plate. The 15-year-old boy had persistent severe chordee after multiple hypospadias procedures. A dorsal buccal mucosal graft was used in 3 cases and cadaveric dermal graft was used in 1. The goal of dorsal graft application in each case was to create a uniform urethral plate 1 cm. wide to promote successful 1-stage penile flap onlay reconstruction.


RESULTS
No patient has required further instrumentation and all void without difficulty. In the 15-year-old boy chordee has completely resolved.


CONCLUSIONS
Using dorsal grafts to salvage an inadequate urethral plate during 1-stage penile island flap onlay reconstruction obviates flap tubularization.
Morey
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AF
Urology Service, Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012074:Remission Induction; D012720:Severity of Illness Index; D013524:Surgical Flaps; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*