Management of urethral stricture: dorsal flap from buccal mucosa – the gold standard

Česká verzia

Authors: A. Čermák; D. Pacík
Authors place of work: Urologická klinika FN Brno
Published in the journal: Urol List 2011; 9(1): 11-19

Summary

A whole variety of techniques have been used for the reconstruction of bulbar urethra stricture. Free skin grafts or transferred cutaneous flaps from penile skin have been long considered as the most suitable tissue material for substitution urethroplasty in urethral stricture management. However, the complications associated with wound healing or graft rejection, occurrence of diverticles or scarring restricted the chances for successful outcome. The mechanical support of graft is considered the most critical factor for treatment success. Ventral graft placement was abundantly used due to the easy chirurgical access and suitable graft bed characteristics provided by spongious tissue. However, compared with the surface of corpora cavernosa, which provides a good mechanical support, is bed from spongious tissue considered suboptimal. Dorsal graft placement enables adequate graft spread over tunica albuginea corpora cavernosa along the entire length of stricture. Graft fixation prevents graft contracture or retraction and adhesion of the surface ensures good revascularization. The currently available long term follow-up data seems promising (compared to the older techniques).

Key words:
urethral stricture, buccal mucosa, graft, urethroplasty, urethral reconstruction

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