title: Scrotal hitch procedure to prevent apical necrosis of scroto-perineal flap for urethroplasty.
abstract: OBJECTIVE
  To present our experience with scrotal hitch technique to prevent necrosis of apex of scroto-perineal flap during two staged open urethroplasty for long segment complex anterior urethral strictures.
  
  
  METHODS
  Over the past 6 years, 22 patients underwent two-staged urethroplasty at our institution. All the strictures were laid open during first stage along with scrotal hitch. The stitch was removed after 7 days.
  
  
  RESULTS
  The flap was healthy in all 22 patients at the time of second stage. Neo-meatal stenosis was not seen in any of the patients. One patient had local site collection, which was cured by topical antibiotics.
  
  
  CONCLUSIONS
  This technique is simple, cost effective, which minimizes the drag over the flap by the shaft of the Foley catheter and thus prevents its pressure necrosis. The technique is particularly helpful in cases of thick, bulky scrotum and does not cause any morbidity, instead allows for early, comfortable ambulation and obviates the need of cumbersome scrotal supportive dressings.
authors.affiliation: Senior Resident in Surgery, King George Medical University, Sector-20, house no-25, Indira nagar, Lucknow, UP, India. priydarshiranjan@sify.com
authors.forename: Priyadarshi
authors.initials: P
authors.lastname: Ranjan
authors.forename: Divaker
authors.initials: D
authors.lastname: Dalela
authors.forename: Apul
authors.initials: A
authors.lastname: Goel
authors.forename: Satya Narayan
authors.initials: SN
authors.lastname: Sankhwar
authors.forename: Vishwajit
authors.initials: V
authors.lastname: Singh
mesh_terms: D006801:Humans; D008297:Male; D009336:Necrosis; D010502:Perineum / Q000473:pathology*; D012189:Retrospective Studies; D012611:Scrotum / Q000473:pathology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*