Initial experience with fibrin sealant in pendulous urethral reconstruction. Is early catheter removal possible?
OBJECTIVE
We assessed whether fibrin sealant promotes early catheter removal after pendulous urethral reconstruction.


METHODS
Between 1997 and 2003, 43 men with complex stricture disease underwent pendulous urethral reconstruction by a single surgeon (AFM). In 18 consecutive cases with a mean stricture length of 7.24 cm from 2000 to 2003 fibrin sealant was applied over a ventral onlay anastomosis performed with running 5-zero polydiaxanone suture. Results were compared with those in 25 men who underwent the procedure without fibrin sealant from 1997 to 2000, who served as a control group (mean stricture length 8.30 cm, p = 0.418). Catheter duration was recorded after anastomosis integrity was radiographically confirmed.


RESULTS
All 18 patients with sealant were completely healed within 14 days, which was significantly shorter than in controls (p <0.001). In the sealant group increased stricture length was associated with longer catheter time (p = 0.677). Our impressions were that patient satisfaction was enhanced by early catheter removal, and postoperative penile edema and ecchymosis were decreased in the fibrin sealant group.


CONCLUSIONS
Fibrin sealant appears to promote early catheter removal and enhanced wound healing after pendulous urethral reconstruction.
Hick
Eric J
EJ
Urology Service, Brooke Army Medical Center, San Antonio, Texas, USA.
Morey
Allen F
AF
D015718:Fibrin Tissue Adhesive; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D014014:Tissue Adhesives; D014525:Urethral Stricture / Q000601:surgery*; D014546:Urinary Catheterization; D013521:Urologic Surgical Procedures, Male / Q000379:methods
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives