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urethral stricture Quartey's urethroplasty perineo-penile degloving exposure.
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Perineo-penile Degloving Exposure in Quartey's Urethroplasty: A Preliminary Report
Abstract
Objective: To present a technique of stricture exposure in Quartey's urethroplasty.
Methods: A retrospective analysis of case files of seven patients that underwent perineo-penile degloving (PPD) exposure for Quartey's urethroplasty was done and formed the basis of this communication.The perineo-penile degloving exposure involves a midline perineal incision to expose the bulbar urethral and a circumcising incision to deglove the penis which is later delivered to the perineum through the retro-scrotal tunnel. The urethroplasty is then done in a single operation field.
Results: Seven patients with long segment urethra stricture were repaired using PPD exposure during the study period. The age ranged from 35 to 70 years with a mean of 48.6±11.1 years. The peno-bulbar site was involved in six (85.7%) of the patients. The mean intra-operative length of the stricture is 7.6±1.5cm. All the patients had Quartey's flap for their reconstruction under spinal anaesthesia with mean operation time of 3.16±0.50 hours (range 2.30 – 4.00 hours). They all had ventral on-lay repair except for one patient who had tubularization of the flap and anastomosis.
Three of the patients had excellent short-term outcome. However, one patient developed slight distal penile skin necrosis, two patients had perineal wound infection and one patient could not void despite patent urethra postoperatively.
Of the patients, only one had extravasation of contrast on pericatheter urethrogram which warranted leaving the urethral catheter for one more week. The mean follow-up period was 8.3±4.5 months with a range of 3 to 14 months. There has being no evidence of recurrence clinically or urodynamically thus far.
Conclusion: PPD is convenient and allows tension-free, water-tight reconstruction in a single operation field with a
comparable short-term outcome.
Key words: urethral stricture, Quartey's urethroplasty, perineo-penile degloving, exposure.
Methods: A retrospective analysis of case files of seven patients that underwent perineo-penile degloving (PPD) exposure for Quartey's urethroplasty was done and formed the basis of this communication.The perineo-penile degloving exposure involves a midline perineal incision to expose the bulbar urethral and a circumcising incision to deglove the penis which is later delivered to the perineum through the retro-scrotal tunnel. The urethroplasty is then done in a single operation field.
Results: Seven patients with long segment urethra stricture were repaired using PPD exposure during the study period. The age ranged from 35 to 70 years with a mean of 48.6±11.1 years. The peno-bulbar site was involved in six (85.7%) of the patients. The mean intra-operative length of the stricture is 7.6±1.5cm. All the patients had Quartey's flap for their reconstruction under spinal anaesthesia with mean operation time of 3.16±0.50 hours (range 2.30 – 4.00 hours). They all had ventral on-lay repair except for one patient who had tubularization of the flap and anastomosis.
Three of the patients had excellent short-term outcome. However, one patient developed slight distal penile skin necrosis, two patients had perineal wound infection and one patient could not void despite patent urethra postoperatively.
Of the patients, only one had extravasation of contrast on pericatheter urethrogram which warranted leaving the urethral catheter for one more week. The mean follow-up period was 8.3±4.5 months with a range of 3 to 14 months. There has being no evidence of recurrence clinically or urodynamically thus far.
Conclusion: PPD is convenient and allows tension-free, water-tight reconstruction in a single operation field with a
comparable short-term outcome.
Key words: urethral stricture, Quartey's urethroplasty, perineo-penile degloving, exposure.
