Experience with Quartey's Distal Penile Island Skin Flap Urethroplasty in South Western Nigeria

Abstract

Objective: To evaluate our experience with Quartey's distal penile island skin flap urethroplasty in the treatment of urethral stricture in two tertiary hospitals in South Western Nigeria. Patients and Methods: Between June 2002 and May 2005, 18 patients with a mean age of 42.2 years (range: 25 – 75 years) underwent distal penile island skin flap urethroplasty for urethral strictures in two tertiary hospitals in Western Nigeria. The medical files of all these patients were reviewed and all data regarding the patients' age, etiology and location of the stricture, indication for urethroplasty, length of stricture, duration of hospitalization, complications of operation and outcome of surgery were analyzed. All patients were subjected to preoperative ascending and/or descending urethrogram. The outcome of surgery was assessed as good when there was a satisfactory stream of urine on direct observation and/or a good flow rate of >15mls/sec, when retrograde urethrocystography revealed a patent lumen and when the post void residual urine volume was < 100 ml after discontinuation of urethral catheterization. Results: The etiology of the urethral stricture was post infective in 77.8% and post traumatic in 22.2%. In 77.8% of the cases, the strictures were located in the bulbar region, in 11.1% in the pendulous urethra and in 5.5% each in the membraneous and bulbo-membranous urethra. The length of the stricture was between 3cm and 7cm in about 61% of the patients. The outcome of surgery was considered good in 17 patients who underwent urethroplasty as a primary procedure and poor in the only patient with recurrent stricture. Conclusion: The ease of flap reconstruction and its reliability to cover large urethral defects has endeared the technique to surgeons in our environment. Being a single stage procedure not requiring multiple admissions and at the same time offering low complication rates, this technique is suitable for patients in developing countries like ours.

African Journal of Urology Vol. 12 (4) 2006: pp. 177-182