title: Salvage urethroplasty using skin grafts for previously failed long-segment urethral strictures.
abstract: The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes. Reconstruction of the urethra with skin grafting was successful in 18 out of the 26 procedures during the first attempt (69%). A "redo" skin grafting was performed for the eight failed cases, with four successful procedures (50%). Overall, the success rate was 84% (22 out of 26 urethral strictures); however, the failed cases developed abscesses and later, ureterocutaneous fistulas. No hair formation from the skin grafts was seen. Skin grafts provide useful alternative graft sources for previously failed long-segment urethral strictures in which the buccal mucosae are not available or are insufficient for salvage urethroplasties with an acceptable success rate.
authors.affiliation: Department of Urology, Medicana International Istanbul Hospital, Istanbul, Turkey.
authors.forename: Cuneyd
authors.initials: C
authors.lastname: Sevinc
authors.affiliation: Department of Urology, Medicana International Istanbul Hospital, Istanbul, Turkey. Electronic address: muhsinbalaban1980@yahoo.com.
authors.forename: Muhsin
authors.initials: M
authors.lastname: Balaban
authors.affiliation: Department of Urology, Kolan International Hospital, Istanbul, Turkey.
authors.forename: Orkunt
authors.initials: O
authors.lastname: Ozkaptan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medicana International Istanbul Hospital, Istanbul, Turkey.
authors.forename: Necmettin
authors.initials: N
authors.lastname: Kutlu
authors.affiliation: Department of Urology, Medicana International Istanbul Hospital, Istanbul, Turkey.
authors.forename: Tahir
authors.initials: T
authors.lastname: Karadeniz
mesh_terms: D000293:Adolescent; D006801:Humans; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy; D016038:Skin Transplantation; D017211:Treatment Failure; D014525:Urethral Stricture / Q000601:surgery*; D013520:Urologic Surgical Procedures; D055815:Young Adult
keywords: Reconstructive surgical procedures; Salvage urethroplasty; Skin transplantation; Urethral stricture