title: Dorsal onlay skin graft bulbar urethroplasty: long-term follow-up.
abstract: OBJECTIVE
  To report retrospectively long-term follow-up in a homogeneous group of patients who underwent dorsal onlay skin graft bulbar urethroplasty and to investigate which factors might influence long-term outcome.
  
  
  METHODS
  Thirty-eight patients, with an average age of 43 yr, underwent dorsal onlay skin graft (#12 ventral penile skin and #26 preputial mucosa) bulbar urethroplasty from 1994 to 2000. Of 38 patients, 23 (60.5%) had undergone prior endoscopic procedures. Preoperative evaluation included clinical history, physical examination, retrograde and voiding urethrography, and urethral sonography. Three weeks after surgery, voiding cystourethrography was performed. Patients were followed-up with a clinical evaluation and specific diagnostic tests every 4 mo in the first year and every 12 mo thereafter. Clinical outcome was considered a failure when postoperative instrumentation, including dilation, was needed.
  
  
  RESULTS
  Average follow-up was 111 mo (range, 80-149). Of 38 cases, 25 (65.8%) were successful and 13 (34.2%) failures. Patients with stricture length > 6 cm and a previous history of urethrotomies or dilatations seemed to have a higher risk of failure, but this observation was only a trend and did not reach levels of statistical significance.
  
  
  CONCLUSIONS
  Penile skin used as dorsal onlay graft for bulbar urethral reconstruction in a homogeneous series of patients showed a success rate ranging from 90% at short-term follow-up to 66% after long-term follow-up. There was no evidence for particular risk factors (length of stricture, number of dilatations and urethrotomies) for failure.
authors.affiliation: Center for Reconstructive Urethral Surgery, Arezzo, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Barbagli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003558:Cystoscopy; D019160:Endosonography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000000981:diagnostic imaging / Q000473:pathology; D014525:Urethral Stricture / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D014567:Urography; D013521:Urologic Surgical Procedures, Male / Q000379:methods*