PEDICLED PERINEAL SKIN FLAP URETHROPLASTY FOR BULBAR URETHRAL STRICTURE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 33
Abstract
BACKGROUND In patients with submucous fibrosis, free skin graft, penile foreskin and Wolfe graft are useful alternatives. In patients with history of circumcision and with recurrent episodes of balanoposthitis, we used perineal skin as urethral substitute. This study is unique with regard to flap design and simplicity of the technique. It can be done under regional anaesthesia and is a less morbid procedure. We retrospectively reviewed the records of patients treated for bulbar urethral strictures using pedicled perineal flap through a perineal incision. We evaluated the feasibility, reproducibility and results of this technique. MATERIALS AND METHODS We report an observational, descriptive, retrospective analysis of 40 consecutive male patients evaluated and treated for bulbar urethral stricture disease using pedicled perineal skin flap. Parameters analysed were age, site and length of stricture, peroperative findings, post-op findings of calibration and complications encountered. RESULTS Mean age of patient was 32.5 years. Mean follow-up was 42 months. Mean stricture length was 4.2 cm (2 to 7 cm). Flow rate increased from average of 4 mL/second (2 - 7 mL/sec) to 16 mL/sec (14 – 22 mL/sec). Of the 40 patients, treatment was successful in 31 (77.5%) and it failed in 9 (22.5%). CONCLUSION Perineal skin is a useful alternative in patients with bulbar urethral stricture and having history of circumcision and having oral submucous fibrosis due to tobacco chewing. Our technique is unique due to its simplicity and ease. It can be done under regional anaesthesia. It stands as yet another option in patients with unhealthy buccal mucosa.
Authors and Affiliations
Kumar Rohit, Prabhat Kumar, Khalid Mahmood, Rohit Upadhyay, Kamalkant Kamalkant, Vijoy Kumar
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