The tunica vaginalis dorsal graft urethroplasty: initial experience
Autor: | Adriano A. Calado, Raimundo Janio, Roberto C. Foinquinos, Antonio Macedo, Adriana Griz, Valdemar Ortiz |
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Jazyk: | angličtina |
Rok vydání: | 2007 |
Předmět: |
Adult
Male Dorsum urethroplasty medicine.medical_specialty endocrine system Urologic Surgical Procedures Male Urethral stricture Urology Urethroplasty medicine.medical_treatment Foley catheter lcsh:RC870-923 urologic and male genital diseases Surgical Flaps Tunica albuginea (ovaries) Serous Membrane medicine Humans Aged business.industry Genitourinary system urogenital system Anastomosis Surgical Tunica vaginalis Mouth Mucosa tunica vaginalis Anatomy Middle Aged medicine.disease lcsh:Diseases of the genitourinary system. Urology Surgery medicine.anatomical_structure Urethra surgical procedures operative urethral stricture urethra business Follow-Up Studies |
Zdroj: | International braz j urol, Volume: 33, Issue: 4, Pages: 523-531, Published: AUG 2007 International Brazilian Journal of Urology, Vol 33, Iss 4, Pp 523-531 (2007) International braz j urol v.33 n.4 2007 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU |
Popis: | INTRODUCTION: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using tunica vaginalis grafts, placed dorsally, for the treatment of anterior urethral strictures. SURGICAL TECHNIQUE: A total of 11 patients with anterior urethral strictures were treated with a tunica vaginalis graft urethroplasty. The surgical technique was done as described by Barbagli. The urethra was dissected from the corpora cavernosa and rotated 180 degrees. The dorsal urethral surface was exposed and fully opened. Both the distal and proximal lumina were calibrated. The tunica vaginalis graft was sutured, splayed and quilted over the corpora cavernosa using 6-0 PDS running stitches. The left side of the urethral mucosa was sutured to the graft using 6-0 PDS sutures. A 18F silicone Foley catheter was inserted at this point. The urethra was rotated back to its original position and sutured laterally to the right side of the graft. At the end of the procedure, the graft was completely covered by the urethra. With a follow-up ranging from 7 weeks to 5 months, all patients were voiding well (uroflowmetry > 14 mL per second). CONCLUSION: This initial experience in 11 patients indicates that tunica vaginalis dorsal graft urethroplasty may be considered within the reconstructive armamentarium of genitourinary surgeons. |
Databáze: | OpenAIRE |
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