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BMJ Case Reports 2011; doi:10.1136/bcr.10.2010.3409
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Dorsolateral onlay urethroplasty for pan anterior urethral stricture by a unilateral urethral mobilisation approach

  1. Rakesh Biswas2
  1. 1Department of Genitourinary surgery, People’s College of Medical Sciences, Bhopal, Madhya Pradesh, India
  2. 2Department of General Surgery, People’s College of Medical Sciences, Bhopal, Madhya Pradesh, India
  3. 3Department of Dermatology & Venereology, People’s College of Medical Sciences, Bhopal, Madhya Pradesh, India
  4. 4Department of Surgery, People’s College of Medical Sciences, Bhopal, Madhya Pradesh, India
  1. Correspondence to Dr Ranjit Chaudhary, drnidhiranjit{at}gmail.com

Summary

The preferred management of urethral strictures involving long segments of anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischaemia of the urethra in addition to chordee. The authors managed a pan anterior urethral stricture, applying a dorsolateral free graft by unilateral urethral mobilisation through a perineal approach. This is a recently described surgical technique which preserves the lateral vascular supply on one side thereby minimising ischaemia. Since circumferential mobilisation of urethra is not carried out in this technique, there are no chances of developing a chordee. Entire procedure is carried out by a perineal incision and no incision is made on the penis except for meatotomy. The pendulous urethra is accessed by penile eversion through the perineal wound. Obviating penile incisions minimises chances of wound infection and fistula formation.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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