[Single stage reconstructive operations of the male urethra].
The male urethra with its anatomic and tissue characteristics demands a differential approach in its reconstruction. The single stage operations, with using of a different plastic material as a treatment of some diseases of the male urethra (hypospadias, strictures), are already quite common to the urological practice. The authors are offering a retrospective analysis to the reconstructive operations of the male urethra with using a plastic material from the preputium and the skin of the penis.


METHODS
For a period of 10 years 94 patients were followed ont: hypospadias--51 (53.9%); strictures--27 (28.7%); fistulas--16 (18%). Were described different operative techniques, but in all patients were used a one stage act. In patients with hypospadias we used five different techniques according to the sort of hypospadias. In patients with strictures we used three methods: with preputial flap; with circular flap from the dorsum of the penis and with a parallel longitudinal to the urethra flap from the ventral surface of the penis.


RESULTS
From the first group of patients we had 17 (33.3%) with anterior hypospadias, 28 (54.9%) with middle, and 6 (11.8%) with posterior hypospadias. We achieved a full correction of the penis in 96.1% of the cases. We marked postoperative fistulas in 7 (13.7%) patients. In the second group of patients we marked 4 (14.8%) cases with postoperative Fistulas; restrictures in 2 (7.4%) cases and diverticul of the urethra in 1 (3.8%) case. In the third group fistulas were formed after urethroplasty in 11 (68.7%) cases and traumas and uroflegmons in 5 (31.3%) cases. We marked refistulisation in 5 cases.


CONCLUSIONS
The urethroplasty with pedicular skin flaps from the preputium and the skin of the penis is a method of choice in patients with anterior strictures of the urethra. The single stage reconstructive operations of the male urethra are quite effective and promising.
Slavov
Ch
Ch
Ianev
K
K
Kirilov
S
S
Chukov
I
I
Panchev
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*