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Surgery in Motion

One-stage Penile Urethroplasty Using Oral Mucosal Graft and Glue

By: Guido Barbaglia, Graziella Pellegrinib, Francesca Corradinib, Francesco Montorsic, Salvatore Sansaloned, Denis Butnarue and Massimo Lazzerif

European Urology, Volume 70 Issue 6, December 2016, Pages 1069-1075

Published online: 01 December 2016

Keywords: Penile stricture, One-stage urethroplasty, Oral mucosal graft, Glue

Abstract Full Text Full Text PDF (4,1 MB)

Abstract

Background

Repair of penile urethral strictures is a challenging problem for which different techniques have been suggested.

Objective

To describe a new surgical technique for one-stage penile urethroplasty using an oral graft and glue, and to assess its safety and efficacy.

Design, setting, and participants

A retrospective review of medical records for patients who underwent one-stage penile urethroplasty using oral mucosa and glue from February 2013 to October 2014 was performed.

Surgical procedure

The penile urethra was opened and the urethral plate was incised to create a wide window within which the oral graft was pasted with glue. The urethra was sutured over the catheter.

Outcome measurements and statistical analysis

Clinical data were collected in a database. Intraoperative and postoperative complications and outcomes were assessed. A descriptive statistical analysis was performed.

Results and limitations

Fourteen patients were included in the study. Median operative time was 60 min. The median postoperative stay was 3 d. Three intraoperative and one postoperative complication occurred. In all patients, voiding cystourethrography 2 wk after surgery failed to show urethral fistula or sacculation. No patients complained of penile chordee or sexual dysfunction after surgery. Median follow-up was 16 mo. Among the 14 patients, 12 (85.7%) procedures were successful and two (14.3%) were failures. Study limitations include the small sample size and short follow-up.

Conclusions

An in vitro study and a one-stage reconstruction of penile urethral strictures with an oral mucosa graft and glue showed that the procedure is safe and efficient, but further studies including larger series of patients and longer follow-up are required.

Patient summary

We report on the repair of penile urethral stricture using one-stage urethroplasty with oral mucosa and glue. This new technique was safe and effective, with limited complications and satisfactory outcomes. We plan to increase the use of this technique in the future.

Take Home Message

The combined use of oral mucosa and glue for one-stage penile urethroplasty is safe and efficient and, in our experience, considerably increases the success rate for this type of urethroplasty.

Keywords: Penile stricture, One-stage urethroplasty, Oral mucosal graft, Glue.

Footnotes

a Centro Chirurgico Toscano, Arezzo, Italy

b Centre for Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy

c Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy

d Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy

e Research Institute for Uronephrology, Sechenov First Moscow State Medical University, Moscow, Russia

f Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, Rozzano, Italy

Corresponding author. Department of Urology, Istituto Clinico Humanitas IRCCS, Clinical and Research Center, via Manzoni 56, 20089 Rozzano, Milan, Italy. Tel. +39 02 82244545.

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