Wessells H, McAninch J W
Section of Urology, College of Medicine, University of Arizona, Tucson, USA.
Tech Urol. 1996 Spring;2(1):1-9.
The reconstruction of complex anterior urethral strictures has evolved from free graft urethroplasty to the use of vascularized skin flaps. The circular penile fasciocutaneous flap is based on Buck's fascia, is hairless, and reliably provides 15 cm of skin. We have used this technique in 40 patients with urethral strictures from the fossa navicularis to the veru montanum. Indications include severe spongiofibrosis, penile urethral location, inflammatory or ischemic etiology, and need for complete tube replacement. A successful result was obtained in 85% of patients. Complete tube replacement is less successful than onlay type procedures (77% vs. 96%) and we make every effort to preserve the urethral plate. This technique is the mainstay of our armamentarium for the repair of urethral strictures and also allows an excellent cosmetic result.
