36 DORSAL INLAY SKIN-GRAFT URETHROPLASTY IN PATIENTS OLDER THAN 65 YEARS
2010-03-23

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery I1 Apr 201036 DORSAL INLAY SKIN-GRAFT URETHROPLASTY IN PATIENTS OLDER THAN 65 YEARS Christian Schwentner, Joerg Seibold, Daniela Colleselli, Jens Mundhenk, David Schilling, Arnulf Stenzl, and Christian Radmayr Christian SchwentnerChristian Schwentner Tuebingen, Germany More articles by this author , Joerg SeiboldJoerg Seibold Tuebingen, Germany More articles by this author , Daniela ColleselliDaniela Colleselli Tuebingen, Germany More articles by this author , Jens MundhenkJens Mundhenk Tuebingen, Germany More articles by this author , David SchillingDavid Schilling Tuebingen, Germany More articles by this author , Arnulf StenzlArnulf Stenzl Tuebingen, Germany More articles by this author , and Christian RadmayrChristian Radmayr Innsbruck, Austria More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.081AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Single-stage dorsal inlay graft urethroplasty has been proven to be effective for anterior urethral reconstruction. However, despite an aging population, the results of this technique in elderly patients have not yet been explicitly reported. Herein, we present our experience with dorsal inlay graft urethroplasty in this selected cohort. METHODS We reviewed all urethroplasties performed on males older than 65 years with at least 6 months of follow-up in our institution. All patients exhibited extensive anterior urethral strictures precluding anastomotic urethroplasty. After excision of fibrotic tissue a free penile or groin skin graft was sutured and quilted to the corpora cavernosa guaranteeing sufficient blood supply. The neourethra was tubularized and covered with a tunica vaginalis or dartos flap in a single stage. Pre- and postoperative voiding cystograms, urethral ultrasound as well as flow measurements were performed in all patients. RESULTS A total of 42 men (mean age 69.25 years, 65-82) underwent dorsal inlay graft urethroplasty. Mean graft length was 7.67 cm (3-16) while penile skin was used in 29 and groin skin in 13 cases, respectively. Average follow-up was 57.17 months (29-82). Complications occurred in 4 patients (9.5%) including fistula formation in 2 cases. Stricture recurrence was noted in 2 patients in whom single direct vision internal urethrotomy was applied successfully. Hence, final success rate was as high as 95.2%. Compared to patients younger than 65 years there were slightly more failures, but this was not statistically significant. Despite prolonged lithotomy position we did not observe neurovascular lower extremity abnormalities. Generally, perioperative complications were uncommon. CONCLUSIONS Dorsal inlay skin-graft urethroplasty can be reliably used in older men with extensive urethral strictures. Although recurrence rates seem to be slightly higher urethroplasty is generally well tolerated in this selected cohort of patients. Given the favourable outcome of the dorsal inlay technique, urethral reconstruction should not be withheld solely on the basis of age. Regarding the lifelong benefits of repair the increased complication rates appear negligible. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e15-e16 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Schwentner Tuebingen, Germany More articles by this author Joerg Seibold Tuebingen, Germany More articles by this author Daniela Colleselli Tuebingen, Germany More articles by this author Jens Mundhenk Tuebingen, Germany More articles by this author David Schilling Tuebingen, Germany More articles by this author Arnulf Stenzl Tuebingen, Germany More articles by this author Christian Radmayr Innsbruck, Austria More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...