WEI Qiang 1 , LIU Jiumin 2
  • 1Department of Kidney Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou Guangdong, 510515, P.R.China;;
  • 2Department of Urology, Guangdong Provincial People’s Hospital.;
Pedicled scrotal septal flap; Long-segment posterior urethral stricture; Urethroplasty; Urethral reconstruction
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Objective To investigate the therapeutic effect of pedicled scrotal septal flap urethroplasty on longsegment posterior urethral stricture and to assess its appl ication value. Methods From January 2003 to December 2007, 24 patients (age range, 6-54 years old) with long-segment urethral stricture underwent pedicled scrotal septal flap urethroplasty.
The duration of the disease was 1-5 years. The stricture was caused by traumatic urethral injury or disruption in 22 cases,
postoperative compl ication of suprapubic transvesical prostatectomy in 1 case, and recurrent urethral infection due to long-term indwell ing urinary catheter in 1 case. Urethroscopy or cystourethrography examination confirmed that all cases had urethral stricture 2.0-5.5 cm in length. Eleven cases were compl icated with urethral false passage, 6 with urethral fistula, 2 with intestinal fistula, and 6 with erectile dysfunction. The result of excretion urography of bilateral upper urinary tracts was negative in all cases. Pedicled scrotal septal flap 2.5 cm × 2.0 cm-6.5 cm × 2.5 cm in size was harvested during operation, and urethroplasty was performed. Results Volume of blood loss during operation was 100-500 mL (average 270 mL). The operative time was 90-220 minutes (average 135 minutes). All flaps survived. All wounds healed by first intention. All patients had normal urination after operation. Over the follow-up period of 12-36 months (average 18.6 months), 1 of the 24 patients suffered from urinary incontinence, 2 from urethral stricture, 1 from urethral stricture and urethral fistula, and 1 from urethral diverticulum around the distal anastomosis. Those patients got normal urination after symptomatic treatment. No urethral stone, urinary incontinence, and new case of erectile dysfunction occurred. The maximum urinary flow rate 16 months after operation was 14-21 mL/s (average 17.6 mL/s). Voiding cystourethrography 22 months after operation showed unblocked urinary tract and no formation of stricture and fistula. Conclusion Pedicled scrotal septal flap urethroplasty, featured by simple operative method, easy flap harvest, and high survival rate of flap, is one of safe and effective methods for treating long-segment posterior urethral stricture.

Citation： WEI Qiang,LIU Jiumin. CLINICAL EFFECT OF PEDICLED SCROTAL SEPTAL FLAP URETHROPLASTY ON LONG-SEGMENT POSTERIOR URETHRAL STRICTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2009, 23(8): 937-939. doi: Copy