One-stage urethroplasty using skin flap

  • Introduction
  • Lectures
  • Articles
  • F.A.Q.
  • Results
  • Surgical Techniques
The surgical technique of “One-stage penile urethroplasty with skin or oral mucosal graft” is made by opening the urethra at the level of the stricture site and widening the urethral lumen by applying a skin or oral graft. There are three basic types of One-stage penile urethroplasty:

  • One-stage penile urethroplasty using skin flap. Using this technique, the urethral plate is augmented using a skin penile flap (figure 1).
  • One-stage penile urethroplasty with oral mucosal graft. Using this technique, the urethral plate is augmented by a transplant of an oral graft (figure 2).
  • One-stage penile urethroplasty with skin graft. Using this technique, the urethral plate is augmented by a transplant of a skin graft (figure 2).

The surgical technique of One-stage penile urethroplasty with skin or oral mucosal graft is generally suggested in the following cases:

  • patients no-obliterative penile urethral strictures, more than 2 cm in length (figure 3).

Figure 1

Figure 2

Figure 3

Lecture n° 1:

Which type of urethroplasty – a critical overview of results and complications
22nd Annual EAU Congress
March 21-24, 2007
Berlin – Germany

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Lecture n° 2:
Which type of urethroplasty. A critical overview of results and complications
23rd Annual EAU Congress
ESU Course 8
March 26-29, 2008
Milan – Italy
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Lecture n° 3:
Penile Urethroplasty
III Simposio Internacional de Cirurgia Urologica Reconstrutora
April 11-12, 2008
Rio de Janeiro-Brazil
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Lecture n° 4:
Urethral Reconstructive Surgery: Current Trends
Portuguese Andrological Association National Meeting
June 21 – 23, 2008
Porto – Portugal
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Lecture n° 5:
Penile and bulbar urethroplasty Surgical techniques and results
Hong Kong Urological Association Urethroplasty Workshop Division of Urology – Tuen Mun Hospital
Hong Kong
February 9 – 10, 2009
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Article n° 1
Guido Barbagli, Giuseppe Morgia and Massimo Lazzeri
Retrospective outcome analysis of one-stage penile urethroplasty using a flap or graft in a homogeneous series of patients
B J Urol Int, 2008: 102, 853-860

Patients and Methods: Sixty-three patients had a penile urethroplasty using one-stage techniques; 18 (29%) had a one-stage flap urethroplasty and 45 (71%) a one-stage urethroplasty using skin (23) or oral mucosal (22) grafts. The clinical outcome was considered a failure when any instrumentation was needed after surgery.
Results: The mean follow-up was 55 months; of the 63 procedures, 48 (76%) were successful and 15 (24%) failures. Of 18 patients who had a one-stage flap urethroplasty, 12 (67%) were successful and six (33%) were failures; of the 45 who had one-stage graft urethroplasty, 36 (80%) were successful and nine (20%) were failures; of 23 penile skin grafts, 18 (78%) were successful and five (22%) were failures; and of 22 oral mucosal grafts, 18 (82%) were successful and four (18%) were failures.
Conclusions: The use of grafts for one-stage penile urethroplasty gave a higher success rate (80%) than flaps (67%). The difference in the success rate between oral mucosal grafts (82%) and skin grafts (78%) was not clinically significant.
1. Question: What kind of anesthesia is used for this surgery?
Answer: General anesthesia with oro-tracheal tube.

2. Question: How many hours does the surgery take?
Answer: About 2 hours.

3. Question: Are there any risks concerning erection, fertility and urinary incontinence after the surgery?
Answer: No, there aren’t.

4. Question: How many days of hospital recovery are expected following the surgery?
Answer: In general, from 5 to 7 days.

5. Question: How long will I have to use a catheter after the surgery? Is it painful to use the catheter?
Answer: The catheter must stay in place for two or three weeks after the surgery. The catheter is well tolerated because of its small diameter.

6. Question: Are there any particular recommendations during convalescence?
Answer: During convalescence, the use antibiotics until the catheter is removed is suggested. Avoiding long car trips, as well as heavy labor and sexual and sports activities are also suggested.

7. Question: When will I be able to resume my working, sexual and sports activities?
Answer: All these activities can be gradually resumed about 30 days after the removal of the catheter.

8. Question: Can I ride a bike or a motorcycle immediately after the surgery?
Answer: Yes.

9. Question: What kinds of foods and drinks should be avoided after the surgery?
Answer: Beer and sparkling wines should be avoided, as well as large quantities of chocolate, cocoa, nuts and shellfish.