title: Small intestinal submucosa (SIS) graft urethroplasty: short-term results.
abstract: OBJECTIVE
  We evaluated the use of small intestinal submucosa (SIS) graft in penile and bulbar urethroplasties.
  
  
  METHODS
  From 2003 to 2004, 20 men (mean age, 41 yr) with anterior urethral strictures underwent urethroplasty using SIS (COOK) as an inlay or onlay patch graft. Stricture location was penile in 1 patient, bulbar in 16, and penile-bulbar in 3. Average stricture and graft lengths were 3 and 5.7 cm, respectively. A dorsal inlay graft was performed in 14 cases, ventral onlay graft in 1, and dorsal inlay plus ventral onlay in 5. Clinical outcome was considered successful if no postoperative procedure was needed.
  
  
  RESULTS
  Mean follow-up period was 21 mo (range: 13-35 mo). Seventeen cases (85%) were successful and 3 (15%) were failures. No postoperative complications were related to the use of heterologous graft material, such as infection or rejection. Sixteen successes (94%) were bulbar repairs and one a penile-bulbar repair, with stricture and graft average lengths 2.6 and 5.35 cm, respectively. Cystoscopy at 3 mo revealed adequate calibre lumens, but SIS grafted areas were not completely replaced by urothelium. The three failures were penile and penile-bulbar urethral repairs with stricture and graft average lengths of 5.7 and 7.7 cm, respectively. Recurrences showed fibrous tissue involving the grafted area with extension into the penile and bulbar urethra.
  
  
  CONCLUSIONS
  In our short-term results, SIS seems to be a versatile material that may have a role in select urethral reconstructions. Longer follow-up and further investigations in select patients are needed before widespread use is advocated.
authors.affiliation: Dipartimento di Urologia, Ospedale San Giuseppe, Università di Milano, Milano, Italy. enzo.palminteri@inwind.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Palminteri
authors.forename: Elisa
authors.initials: E
authors.lastname: Berdondini
authors.forename: Fulvio
authors.initials: F
authors.lastname: Colombo
authors.forename: Edoardo
authors.initials: E
authors.lastname: Austoni
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010413:Penis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*