title: Tunica albuginea urethroplasty for anterior urethral strictures: a urethroscopic analysis.
abstract: OBJECTIVE
  To assess the efficacy of tunica albuginea urethroplasty (TAU) for anterior urethral strictures.
  
  
  METHODS
  We assessed 206 patients with anterior urethral strictures who underwent TAU. The procedure involves mobilization of strictured urethra and laying it open with a dorsal slit. Edges of the slit-open urethra are sutured to edges of the urethral groove with a silicon catheter in situ. Thus in neourethra, the roof is formed by tunica albuginea of the urethral groove. Results were assessed at 6, 12, 24 and 36 months by comparative analysis of patient satisfaction along with retrograde urethrogram, urethrosonogram, uroflowmetry, and were categorized as good, fair and poor. Good and fair results were considered as successful. Thirty patients were taken for postoperative urethroscopic analysis to allow better understanding of both successful and failed cases.
  
  
  RESULTS
  Postoperative evaluation at 6 months showed a 96.6% success rate, which decreased to 94.7% at 1 year, 93.2% at 2 years and over 90% at the end of 3 years. The overall failure rate was 9.2%, which required revision surgery. Urethroscopic visualization of the reconstruction site showed wide, patent and distensible neourethra uniformly lined by urothelium over roof formed by tunica albuginea of the corpora cavernosa in successful cases. Failure cases showed diffuse fibrotic narrowing or circumferential scarring.
  
  
  CONCLUSIONS
  Tunica albuginea is a locally available distensible tissue, sufficient to maintain the patency of the neourethra, without any graft or flap. TAU is easier and useful when patients have unhealthy oral mucosa due to tobacco chewing.
authors.affiliation: Department of Surgery, M.G.M Medical College and M.Y. Group of Hospitals, Madhya Pradesh, India. rkmmyh60@yahoo.com
authors.forename: Raj K
authors.initials: RK
authors.lastname: Mathur
authors.forename: Adittya K
authors.initials: AK
authors.lastname: Sharma
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Odiya
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000601:surgery*; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*