Penile fasciocutaneous flap urethroplasty for the reconstruction of pediatric long anterior urethral stricture

被引:7
|
作者
Aldaqadossi, H. A. [1 ]
Shaker, H. [1 ]
Kotb, Y. [2 ]
Youssof, H. [1 ]
Elgamal, S. [3 ]
机构
[1] Fayoum Fac Med, Al Fayyum 63514, Egypt
[2] Ain Shams Fac Med, Cairo, Egypt
[3] Tanta Fac Med, Tanta, Egypt
关键词
SKIN-FLAP; MANAGEMENT; CHILDREN; REPAIR; GRAFT;
D O I
10.1016/j.jpurol.2018.07.008
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Though pediatric urethral stricture is an uncommon urological problem, it is a challenging urological one. The causative factors are iatrogenic, traumatic, and inflammatory. In the current study, the authors report their experience of the treatment of pediatric long anterior urethral stricture using penile circular fasciocutaneous flap. Patients and methods The study included 23 pediatric patients who had long anterior urethral strictures, which were repaired using circular penile fasciocutaneous flap. The flap was elevated through a subcoronal circumferential incision and then it was split ventrally. The strictured portion of the urethra was sharply incised ventrally, extending to 1 cm into normal urethra. The flap was sutured to the urethral plate over silicone catheter of suitable size, which was removed after 3 weeks. The follow-up was scheduled every 3 months for the first year and then yearly thereafter. Results The urethroplasty was successful in 20 cases (86.96%). There were two cases complicated by stricture recurrence, which was managed by visual internal urethrotomy. Fistula formation was reported in one case and was repaired by simple excision and closure. Penile skin necrosis was reported in only one patient and was managed by frequent dressing. Discussion During the last five decades, there was a substantial advancement in the reconstruction of long or complex anterior strictures due to the use of grafts and flaps. During pediatric urethral stricture repair, particular attention must be paid to the differences between adults and children anatomy, e.g. the small urethral lumen and tissue delicateness. McAninch introduced the reconstruction of complex anterior urethral strictures utilizing circular penile fasciocutaneous flap. The technique of penile fasciocutaneous flap urethroplasty takes long time and requires meticulous dissection. Therefore, it should be restricted for long or complex anterior urethra strictures. Success rate in this study was 86.96%, which is in the same league as that reported in literature as regard adults penile fasciocutaneous flap urethroplasty. Whitson et al. reported success rates of 84% and 79% in the 5th and 10th years, respectively. In another study, Kim et al. revealed a success rate of 68.9%. In this study, complications incidence was 21.6%, which is consistent with reported incidence of complications of adults penile fasciocutaneous flap urethroplasty (8%-20%). Conclusion According to the outcomes of this study, penile fasciocutaneous flap urethroplasty is a reasonable modality for the reconstruction of long anterior urethral stricture in pediatric patients especially after circumcision.
引用
收藏
页码:555.e1 / 555.e6
页数:6
相关论文
共 50 条
  • [21] Urethroplasty for refractory anterior urethral stricture
    Joseph, JV
    Andrich, DE
    Leach, CJ
    Mundy, AR
    JOURNAL OF UROLOGY, 2002, 167 (01): : 127 - 129
  • [22] Buccal mucosal graft versus penile skin flap urethroplasty for long segment penile urethral stricture: a prospective randomized study
    Ali, Ahmed Issam
    Hamid, Amr Abdel
    Abdel-Rassoul, Mohammed Abdou
    Galal, Ehab M.
    Hasanein, Mohammed G. S.
    Hassan, Mohamed Abd Elmalek
    El-Hawy, Mamdouh M.
    CENTRAL EUROPEAN JOURNAL OF UROLOGY, 2019, 72 (02) : 191 - 197
  • [23] Single-Staged Improved Tubularized Preputial/Penile Skin Flap Urethroplasty for Obliterated Anterior Urethral Stricture: Long-Term Results
    Xue, Jing-Dong
    Xie, Hong
    Fu, Qiang
    Feng, Chao
    Guo, Hui
    Xu, Yue-Min
    UROLOGIA INTERNATIONALIS, 2016, 96 (02) : 231 - 237
  • [24] Penile circular fasciocutaneous skin flap in single-stage reconstruction of complex anterior urethral strictures.
    McAninch, JW
    Morey, AF
    JOURNAL OF UROLOGY, 1998, 159 (05): : 263 - 263
  • [25] Tunica Vaginalis Pedicle Flap for Reconstruction of Anterior Urethral Stricture
    Yaqubi, Abdul-Ali
    Yuan, Wu Wen
    Mei, Shen Hong
    Xiong, Jin Tie
    LUTS-LOWER URINARY TRACT SYMPTOMS, 2014, 6 (01) : 15 - 19
  • [26] Urethroplasty for treatment of long anterior urethral stricture: buccal mucosa graft versus penile skin graft—does the stricture length matter?
    Mohamed M. Hussein
    Hazem Almogazy
    Ahmed Mamdouh
    Fawzy Farag
    Elnesr Rashed
    Wael Gamal
    Ahmed Rashed
    Mohamed Zaki
    Esam Salem
    Ahmed Ryad
    International Urology and Nephrology, 2016, 48 : 1831 - 1835
  • [27] OUTCOMES OF URETHROPLASTY FOR SYNCHRONOUS ANTERIOR URETHRAL STRICTURE
    Jamil, Marcus
    Hansma, Alexandra
    Alsikafi, Nejd
    Breyer, Benjamin
    Broghammer, Joshua
    Buckley, Jill
    Elliott, Sean
    Erickson, Bradley
    Meyers, Jeremy
    Peterson, Andrew
    Rourke, Keith
    Smith, Thomas
    Voelzke, Bryan
    Zhao, Lee
    Vanni, Alex
    JOURNAL OF UROLOGY, 2023, 209 : E1134 - E1135
  • [29] Penile Circular Fasciocutaneous (McAninch) Flap as an Option for Complex Anterior Urethral Stricture in Case of Non-Viable Buccal Mucosal Graft
    Vijayganapathy, Sundaramoorthy
    Mallya, Ashwin
    Karthikeyan, Vilvapathy Senguttuvan
    Sreenivas, Jayaram
    JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2016, 10 (07) : PD9 - PD11
  • [30] MODIFIED ANNULAR PENILE SKIN FLAP FOR REPAIR OF PAN ANTERIOR URETHRAL STRICTURE
    Eldahshoury, Mohmad
    JOURNAL OF MENS HEALTH, 2009, 6 (03) : 231 - 231