Dorsolateral onlay urethroplasty for pan anterior urethral stricture by a unilateral urethral mobilisation approach.
The preferred management of urethral strictures involving long segments of anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischaemia of the urethra in addition to chordee. The authors managed a pan anterior urethral stricture, applying a dorsolateral free graft by unilateral urethral mobilisation through a perineal approach. This is a recently described surgical technique which preserves the lateral vascular supply on one side thereby minimising ischaemia. Since circumferential mobilisation of urethra is not carried out in this technique, there are no chances of developing a chordee. Entire procedure is carried out by a perineal incision and no incision is made on the penis except for meatotomy. The pendulous urethra is accessed by penile eversion through the perineal wound. Obviating penile incisions minimises chances of wound infection and fistula formation.
Department of Genitourinary Surgery, People's College of Medical Sciences, Bhopal, Madhya Pradesh, India. drnidhiranjit@gmail.com
Ranjit
R
Chaudhary
Nidhi
N
Jain
Kulwant
K
Singh
Hari Singh
HS
Bisoniya
Rahul
R
Chaudhary
Rakesh
R
Biswas
D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D014521:Urethra / Q000098:blood supply / Q000601:surgery; D014525:Urethral Stricture / Q000601:surgery*; D014563:Urodynamics; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D055815:Young Adult