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• W2024462854 abstract "No AccessJournal of UrologyAdult Urology1 May 2010Urethroplasty With Abdominal Skin Grafts for Long Segment Urethral Strictures Joshua J. Meeks, Bradley A. Erickson, Philip Fetchev, Susan E. Crawford, Neil A. Fine, and Chris M. Gonzalez Joshua J. MeeksJoshua J. Meeks Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois Supported by an AUA Research Scholar grant from the AUA Foundation with contributions from Sanofi-Aventis. More articles by this author , Bradley A. EricksonBradley A. Erickson Department of Urology, University of California San Francisco, San Francisco, California More articles by this author , Philip FetchevPhilip Fetchev Department of Surgery, NorthShore University Hospital, Evanston, Illinois More articles by this author , Susan E. CrawfordSusan E. Crawford Department of Surgery, NorthShore University Hospital, Evanston, Illinois More articles by this author , Neil A. FineNeil A. Fine Division of Plastic Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois More articles by this author , and Chris M. GonzalezChris M. Gonzalez Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.01.029AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Buccal derived graft tissue has been proven to be useful in urethral reconstruction. However, nonbuccal sources are often needed for long segment strictures or for those with prior buccal harvest. We describe a technique using full-thickness abdominal skin grafts for long segment urethroplasty and present the short-term outcomes. Materials and Methods: A total of 21 men underwent urethroplasty for strictures of an average of 11 cm (range 4 to 24) using abdominal wall skin. Prior urethroplasty was performed in 52% of patients and multistage repair was conducted in 48%. Results: The recurrence rate following urethroplasty was 19%, with 9.5% requiring revision after first stage urethroplasty. Complications included hair from the skin graft during the early part of the series (14.5%), glans dehiscence (9.5%), urethrocutaneous fistula (9.5%) and periurethral abscess (1 patient). Histological evaluation at 6 months demonstrated excellent uptake of grafts with minimal keratinization. Conclusions: In men with significant penile scarring, lichen sclerosis and long segment urethral strictures the use of abdominal skin limits donor site morbidity, and provides a useful alternative graft source for urethroplasty when buccal mucosa or genital skin are not available or sufficient. Grafts should be harvested from nonhair bearing areas to minimize the risk of urethral hair development. References 1 : Buccal mucosal urethroplasty: a versatile technique for all urethral segments. BJU Int2005; 95: 625. Google Scholar 2 : Oral complications after buccal mucosal graft harvest for urethroplasty. BJU Int2004; 94: 867. Google Scholar 3 : Q-flap reconstruction of panurethral strictures. BJU Int2000; 86: 1039. Google Scholar 4 : Urethroplasty for balanitis xerotica obliterans. Br J Urol1998; 81: 735. Google Scholar 5 : Lichen sclerosus: review of the literature and current recommendations for management. J Urol2007; 178: 2268. Link, Google Scholar 6 : Enterourethroplasty–a useful technique for the salvage of bulbo membranous strictures. J Urol2009; 181: 421. abstract 1181. Link, Google Scholar 7 : Buccal mucosa grafts for hypospadias surgery: long-term results. J Urol2002; 168: 1734. Link, Google Scholar 8 : Small intestinal submucosa (SIS) graft urethroplasty: short-term results. Eur Urol2007; 51: 1695. Google Scholar 9 : Substitution urethroplasty of complex and long-segment urethral strictures: a rationale for procedure selection. Eur Urol2007; 51: 1093. Google Scholar 10 : Postauricular skin as an alternative to oral mucosa for anterior onlay graft urethroplasty: a preliminary experience in patients with oral mucosa changes. Urology2009; 74: 345. Google Scholar 11 : The long-term results of skin inlay urethroplasty. Br J Urol1995; 75: 59. Google Scholar 12 : Patterns of contraction in human full thickness skin grafts. Br J Plast Surg2000; 53: 397. Google Scholar © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 5May 2010Page: 1880-1884 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordsskin transplantationurethral stricturereconstructive surgical proceduresMetricsAuthor Information Joshua J. Meeks Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois Supported by an AUA Research Scholar grant from the AUA Foundation with contributions from Sanofi-Aventis. More articles by this author Bradley A. Erickson Department of Urology, University of California San Francisco, San Francisco, California More articles by this author Philip Fetchev Department of Surgery, NorthShore University Hospital, Evanston, Illinois More articles by this author Susan E. Crawford Department of Surgery, NorthShore University Hospital, Evanston, Illinois More articles by this author Neil A. Fine Division of Plastic Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois More articles by this author Chris M. Gonzalez Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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