title: Porcine small intestinal submucosa graft for repair of anterior urethral strictures.
abstract: OBJECTIVE
  We evaluated porcine small intestinal submucosa (SIS) used in the treatment of inflammatory, iatrogenic, posttraumatic, and idiopathic strictures of bulbar and penile urethra. Midterm maintenance of urethral patency was assessed.
  
  
  METHODS
  Fifty patients aged 45-73 yr with anterior urethral stricture underwent urethroplasty using a porcine SIS collagen-based matrix for urethral reconstruction. Stricture was localized in the bulbar urethra in 10 patients, the bulbopenile area in 31 cases, and in the distal penile urethra in nine patients. All patients received a four-layered SIS patch graft in an onlay fashion. A voiding history, retrograde and antegrade urethrography, and cystoscopy were performed preoperatively and postoperatively. Failure was defined as stricture confirmed on urethrogram.
  
  
  RESULTS
  After a mean follow-up of 31.2 mo (range: 24-36 mo), the clinical, radiological, and cosmetic findings were excellent in 40 (80%) patients. Restricture developed in one of 10 bulbar, five of 31 bulbopenile, and four of nine penile strictures. These all occurred in the first 6 mo postoperatively. All patients with recurrences needed further therapy, but there has been no additional recurrence observed to date. No complications such as fistula, wound infection, UTI, or rejection were observed.
  
  
  CONCLUSIONS
  Use of inert porcine SIS matrix appears to be beneficial for patients with bulbar and bulbopenile strictures. Midterm results are comparable to skin flaps and mucosal grafts.
authors.affiliation: Department of Urology, University Hospital, IP Pavlova 6, 779 00 Olomouc, Czech Republic. fialar@atlas.cz
authors.forename: Richard
authors.initials: R
authors.lastname: Fiala
authors.forename: Ales
authors.initials: A
authors.lastname: Vidlar
authors.forename: Radek
authors.initials: R
authors.lastname: Vrtal
authors.forename: Kamil
authors.initials: K
authors.lastname: Belej
authors.forename: Vladimir
authors.initials: V
authors.lastname: Student
mesh_terms: D000368:Aged; D000818:Animals; D006801:Humans; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small / Q000637:transplantation*; D008875:Middle Aged; D013552:Swine; D014183:Transplantation, Heterologous; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*