Preputial skin free graft as dorsal onlay urethroplasty: Our experience of 73 patients.
OBJECTIVE
To present the outcome of dorsal onlay urethroplasty in 73 patients for stricture urethra over a period of eight years.


METHODS
Seventy-three patients of stricture urethra have undergone dorsal onlay urethroplasty from July 1998 to February 2006. Age distribution: 14-58 years.


BACKGROUND
Trauma 20/73 (27.39%), Balanitis Xerotica Obliterans 2/73 (2.73%), Iatrogenic 26/73(35.61%), Infection 3/73 (4.10%), Idiopathic 22/73 (30.13%). Site: Penobulbar-25/73, bulbar-38/73, membranous-8/73 and long length-2/73. Suprapubic catheter was inserted preoperatively: 21/73 patients. Preputial / distal penile skin was used in all patients. Buccal mucosa was not used in any patient. Hospitalization was for four to five days. Catheter was removed after 21 days. All patients had their first endoscopic checkup after three months. Subsequently they were followed up by uroflometry. Routine imaging of urethra for follow-up was not carried out.


RESULTS
63/73 (86.30%) patients had satisfactory outcome not requiring any further treatment, 8/73 (10.95%) developed anastomotic stricture (3/8-optical internal urethrotomy, 5/8 dilatation alone). 2/73 (2.75%) developed external meatal stenosis. None had urinary fistula and required repeat urethroplasty. Follow-up ranged from three months to eight years.


CONCLUSIONS
Dorsal onlay urethroplasty using preputial/distal penile skin is a satisfactory procedure. Preputial/distal penile skin is devoid of hair and fat and hence an ideal graft material. Even in circumscribed patients distal penile skin can be harvested. Long-term follow-up is required in judging results of patients with stricture urethra.
Bapat
Shivadeo S
SS
Dr. YG Bodhe Dept of Urology, Maharashtra Medical Foundation's Ratna Memorial Hospital, 986 Senapati Bapat Road, Pune - 411 004, India.
Padhye
Abhijit S
AS
Yadav
Pushkaraj B
PB
Bhave
Ashish A
AA