Current controversies in reconstructive surgery of the anterior urethra: a clinical overview
AUTOR(ES)
Barbagli, Guido, Sansalone, Salvatore, Djinovic, Rados, Romano, Giuseppe, Lazzeri, Massimo
FONTE
International braz j urol
DATA DE PUBLICAÇÃO
2012-06
RESUMO
We performed an overview of the surgical techniques suggested for the treatment of anterior urethral strictures using MEDLINE. In applying the MEDLINE search, we used the "MeSH" (Medical Subject Heading) and "free text" protocols. The MeSH search was conducted by combining the following terms: "urethral stricture", "flap", "graft", "oral mucosa", "urethroplasty", "urethrotomy" and "failed hypospadias". Multiple "free text" searches were performed individually applying the following terms through all fields of the records: "reconstructive urethral surgery", "end-to-end anastomosis", "one-stage", "two stage". Descriptive statistics of the articles were provided. Meta-analyses were not employed. Seventy-eight articles were determined to be germane in this review. Six main topics were identified as controversial in anterior urethra surgery: the use of oral mucosa vs penile skin; the use of free grafts vs pedicled flaps in penile urethroplasty; the use of grafts vs anastomotic repair in bulbar urethral strictures; the use of dorsal vs ventral placement of the graft in bulbar urethroplasty; the use of definitive perineal urethrostomy vs one-stage repair in complex urethral strictures; the surgical options for patients with failed hypospadias repair. Different points of view are documented and presented in the literature by various authors from different countries. The aim of this clinical overview is to survey the main controversial issues in surgical reconstruction of the anterior urethra focusing on the use of flap or graft, substitute material, type of surgery and challenging situations, such as failed hypospadias or complex urethral stricture repair.
Documentos Relacionados
- Primary transitional cell carcinoma of the anterior urethra: a rare presentation.
- STRICTURE OF THE URETHRA: DISCUSSION
- A new option to prevent fistulas in anterior urethroplasty in patients with kippered urethra: the tunica vaginalis flap
- Management of low velocity gunshot wounds to the anterior urethra: the role of primary repair versus urinary diversion alone
- Metastasis of renal cell carcinoma to the urethra: a rare scenario