To describe and evaluate the efficacy of the slit-integration method in the prevention of ring recurrence after graft substitution urethroplasty.
This was a pilot study of selected patients with urethral stricture disease who required urethroplasty from January 2016 to December 2018. Patients were recruited into the study after they granted informed consent about the procedure.
A total of eight patients were involved in this pilot study. The mean age (±standard deviation, SD) of the patients and the mean stricture length (±SD) were 44.25 (±11.07) years and 3.88 (±1.25) cm, respectively. The peno-bulbar region was the most frequently involved. The majority of the patients, 7 of 8 patients, underwent buccal mucosal graft repair with a mean graft length of 5.88 cm (range, 4-8 cm). There was leak during pericatheter urethrography in one patient. The mean (±SD) urethral calibers of the distal and proximal urethral anastomotic sites following urethroplasty were 26.00 (±1.85) and 25.25 (±1.83) at 1 week after removal of the urethral catheter stent and 27.75 (±0.71) and 27.75 (±0.71) at 12 months postoperatively, respectively. The mean maximum flow rate (±SD) at the 6- and 12-month follow-up was 20.25 (±1.83) and 21.88 (±1.73) mL/s, respectively.
A slit-graft appropriately quilted into the corresponding urethrotomy incisions at the proximal and distal summit of the urethral stricture segments appears to mitigate the occurrence of ring contracture after urethroplasty. A randomized controlled trial of this technique with additional outcome assessment will be required to validate this observation.
Investigative and clinical urology. 2019 Jun 29 [Epub]
Abdulwahab Akanbi Ajape, Sulyman Alege Kuranga, Hamid Babajide Olanipekun, Taofiq Olayinka Mohammed
Division of Urology, Department of Surgery, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria.