COMPARATIVE ANALYSIS OF ONE- AND TWO-STAGE AUGMENTATION URETHROPLASTY WITH DORSAL INLAY BUCCAL GRAFT FOR EXTENDED STRICTURES OF SPONGIOUS URETHRA


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Abstract

Introduction. Urethral reconstructive surgery is in constant development. At present, reconstructive urethroplasty with buccal mucosa is increasingly being used. The study aimed to compare the results of a one- and two-stage augmentation urethroplasty with dorsal inlay buccal graft for strictures of the spongious urethra. Materials and methods. The study comprised 72 patients aged 19-64 with urethral strictures 3-18 cm long. In 34 (47.2%) patients, the stricture was localized in the penile urethra, in 30 patients (41.6%) in the penile-bulbous urethra and in 8 patients (11%) in the bulbous urethra. All patients underwent augmentation urethroplasty with dorsal inlay buccal graft. The results were evaluated separately in 55 (76.4%, group 1) and 17 (23.6%, group 2) patients who underwent one-stage and two-stage surgery, respectively. Results. The incidence rate of early postoperative complications was higher after one-stage (23.6%) compared two-stage surgery (11.8%) (p<0.05). Hematomas, wound dehiscence and urethrocutaneous fistulas were observed only after single-stage surgery. Primary healing of extensive strictures following augmentation urethroplasty with dorsal inlay buccal graft was achieved in 88.9% of patients; treatment effectiveness in the group 1 was 89.1%, in the group 2 - 88.2% (p>0.05). The final effectiveness of the operation, achieved with the use of additional surgical interventions, is estimated at 98.6%. Conclusion. The results of augmentation urethroplasty with dorsal inlay buccal graft do not depend on the number of stages, but fewer complications accompany two-stage surgery.

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About the authors

M. I Kogan

Rostov State Medical University of Minzdrav of Russia

Email: dept_kogan@mail.ru
Dr.Med.Sci., Prof., Head of the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology-Andrology, Faculty of AT and PRS Rostov on Don, Russia

V. P Glukhov

Rostov State Medical University of Minzdrav of Russia

Email: gluhovladimir@rambler.ru
Ph.D., Associate Professor at the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology-Andrology, Faculty of AT and PRS Rostov on Don, Russia

V. V Mitusov

Rostov State Medical University of Minzdrav of Russia

Email: mvv55@list.ru
Dr.Med.Sci., Associate Professor at the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology-Andrology, Faculty of AT and PRS Rostov on Don, Russia

V. V Krasulin

Rostov State Medical University of Minzdrav of Russia

Dr.Med.Sci., Prof. at the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology-Andrology, Faculty of AT and PRS Rostov on Don, Russia

A. V Il’yash

Rostov State Medical University of Minzdrav of Russia

Email: annailyash@yandex.ru
Ph.D., Urologist at the Consultant Outpatient Department Rostov on Don, Russia

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