Management of penile urethral strictures:Challenges and future directions

• 作者: Anastasia Frost Anthony R Mundy Daniela E Andrich Felix Campos-Juanatey Simon Bugeja Stella L Ivaz
• 来源期刊: 世界临床泌尿杂志
• 学科: 医学
• 关键词: RECONSTRUCTIVE surgical procedures Anterior URETHRAL STRICTURE Oral mucosa Tissue TRANSPLANTS Skin grafting HYPOSPADIAS LICHEN sclerosus
• 年，卷（期）: sjlcmnzz_2016,（1）
• 页码范围: 1-10
• 页数: 10页
• 分类号: R

摘要

The anatomy of the penile urethra presents additional challenges when compared to other urethral segments during open stricture surgery particularly because of its unsuitability for excision and primary anastomosis and its relatively deficient corpus spongiosum.Stricture aetiology,location,length and previous surgical intervention remain the primary factors influencing the choice of penile urethroplasty technique.We have identified what we feel are the most important challenges and controversies in penile urethral stricture reconstruction,namely the use of flaps vs grafts,use of skin or oral mucosal tissue for augmentation/substitution and when a single or a staged approach is indicated to give the best possible outcome.The management of more complex cases such as panurethral lichen-sclerosus strictures and hypospadias“cripples”is outlined and potential developments for the future are presented.