TY - JOUR
T1 - Dorsal onlay graft urethroplasty using penile skin or buccal mucosa for repair of bulbar urethral stricture
T2 - Results of a prospective single center study
AU - Raber, Marco
AU - Naspro, Richard
AU - Scapaticci, Emanuele
AU - Salonia, Andrea
AU - Scattoni, Vincenzo
AU - Mazzoccoli, Bruno
AU - Guazzoni, Giorgio
AU - Rigatti, Patrizio
AU - Montorsi, Francesco
PY - 2005/12
Y1 - 2005/12
N2 - Objective: To compare the outcomes of dorsal onlay graft urethroplasty using penile skin (PS) or buccal mucosa (BM) free grafts in the repair of adult bulbourethral strictures. Methods: From January 1998 to March 2003, 30 patients with bulbar urethral strictures underwent urethral reconstruction with PS (17) or with BM free graft (13). Follow-up was done at 6, 12 and 18 months postoperatively, and every year subsequently. Success was defined as normalization of IPSS and a stable Qmax value >20 ml/s. Any further instrumentation for stricture recurrence was considered a failure. Results: Mean follow-up was 51 months (20-74). The overall success rate was 80% (85% in the BM and 76% in the PS group). Improvement of uroflowmetry, IPSS and QoL did not show a significant difference between the two groups. A significant improvement of the orgasmic function domain of the IIEF was found in patients treated with a PS graft. Post-operative complications were lip hypoesthesia (30%), retraction of the ventral skin of the penis (7%), post-voiding dribbling (8% with BM graft, and 7%, with PS graft). Six patients, 2 with BM (15%) and 4 with PS graft patch (24%) required further treatment due to stricture recurrence. Conclusion: Results of PS or BM graft are comparable at 18 month follow-up, although orgasmic function is significantly improved in patients receiving a PS graft. Nevertheless, with extended follow-up, the use of PS seems to be associated with a higher failure rate.
AB - Objective: To compare the outcomes of dorsal onlay graft urethroplasty using penile skin (PS) or buccal mucosa (BM) free grafts in the repair of adult bulbourethral strictures. Methods: From January 1998 to March 2003, 30 patients with bulbar urethral strictures underwent urethral reconstruction with PS (17) or with BM free graft (13). Follow-up was done at 6, 12 and 18 months postoperatively, and every year subsequently. Success was defined as normalization of IPSS and a stable Qmax value >20 ml/s. Any further instrumentation for stricture recurrence was considered a failure. Results: Mean follow-up was 51 months (20-74). The overall success rate was 80% (85% in the BM and 76% in the PS group). Improvement of uroflowmetry, IPSS and QoL did not show a significant difference between the two groups. A significant improvement of the orgasmic function domain of the IIEF was found in patients treated with a PS graft. Post-operative complications were lip hypoesthesia (30%), retraction of the ventral skin of the penis (7%), post-voiding dribbling (8% with BM graft, and 7%, with PS graft). Six patients, 2 with BM (15%) and 4 with PS graft patch (24%) required further treatment due to stricture recurrence. Conclusion: Results of PS or BM graft are comparable at 18 month follow-up, although orgasmic function is significantly improved in patients receiving a PS graft. Nevertheless, with extended follow-up, the use of PS seems to be associated with a higher failure rate.
KW - Buccal mucosa
KW - Grafting skin
KW - Grafting tissue
KW - Urethral stenosis
UR - http://www.scopus.com/inward/record.url?scp=27844601249&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=27844601249&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2005.05.003
DO - 10.1016/j.eururo.2005.05.003
M3 - Article
C2 - 15970374
AN - SCOPUS:27844601249
SN - 0302-2838
VL - 48
SP - 1013
EP - 1017
JO - European Urology
JF - European Urology
IS - 6
ER -