Document Detail

The tunica vaginalis dorsal graft urethroplasty: initial experience.
MedLine Citation:
PMID:  17767758     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using tunica vaginalis grafts, placed dorsally, for the treatment of anterior urethral strictures. SURGICAL TECHNIQUE: A total of 11 patients with anterior urethral strictures were treated with a tunica vaginalis graft urethroplasty. The surgical technique was done as described by Barbagli. The urethra was dissected from the corpora cavernosa and rotated 180 degrees. The dorsal urethral surface was exposed and fully opened. Both the distal and proximal lumina were calibrated. The tunica vaginalis graft was sutured, splayed and quilted over the corpora cavernosa using 6-0 PDS running stitches. The left side of the urethral mucosa was sutured to the graft using 6-0 PDS sutures. A 18F silicone Foley catheter was inserted at this point. The urethra was rotated back to its original position and sutured laterally to the right side of the graft. At the end of the procedure, the graft was completely covered by the urethra. With a follow-up ranging from 7 weeks to 5 months, all patients were voiding well (uroflowmetry > 14 mL per second). CONCLUSION: This initial experience in 11 patients indicates that tunica vaginalis dorsal graft urethroplasty may be considered within the reconstructive armamentarium of genitourinary surgeons.
Roberto C Foinquinos; Adriano A Calado; Raimundo Janio; Adriana Griz; Antonio Macedo; Valdemar Ortiz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International braz j urol : official journal of the Brazilian Society of Urology     Volume:  33     ISSN:  1677-5538     ISO Abbreviation:  Int Braz J Urol     Publication Date:    2007 Jul-Aug
Date Detail:
Created Date:  2007-09-04     Completed Date:  2008-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158091     Medline TA:  Int Braz J Urol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  523-9; discussion 529-31     Citation Subset:  IM    
Division of Urology, State University of Pernambuco, Pernambuco, Brazil.
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MeSH Terms
Anastomosis, Surgical
Follow-Up Studies
Middle Aged
Mouth Mucosa / transplantation*
Serous Membrane / transplantation*
Surgical Flaps*
Urethra / surgery*
Urethral Stricture / surgery*
Urologic Surgical Procedures, Male / methods
Comment In:
Int Braz J Urol. 2007 Sep-Oct;33(5):711-2   [PMID:  17980070 ]

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