Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture

To demonstrate a new minimally invasive endoscopic approach to urethroplasty. The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide...

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Veröffentlicht in:Urology (Ridgewood, N.J.) N.J.), 2023-11, Vol.181, p.e200-e203
Hauptverfasser: Ungerer, Garrett, Kemble, Jayson, Sischka, Michael, Balzano, Felicia L., Warner, Jonathan N.
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creator Ungerer, Garrett
Kemble, Jayson
Sischka, Michael
Balzano, Felicia L.
Warner, Jonathan N.
description To demonstrate a new minimally invasive endoscopic approach to urethroplasty. The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide strip of superficial mucosa was resected from the bladder neck past the area of stricture, creating a bed for the graft to lay. Buccal mucosa graft was harvested in standard fashion. With the graft outside the urethra and using the RD 180 endoscopic suturing device, a suture is placed in the proximal end of the graft, then through the bladder neck, and back through the graft. As the suture is pulled, the pulley phenomenon advances the graft into place on the bladder neck. The graft is then anchored to the posterior urethra with secure straps. A catheter is placed to hold the graft flat during the healing process. The procedure lasted 2.5 hours without any complications. Estimated blood loss was 50cc, and the patient was discharged after the procedure. Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture. Endoscopic urethroplasty using buccal graft appears to offer a safe and effective repair option for management of ureteral strictures.
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Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture. Endoscopic urethroplasty using buccal graft appears to offer a safe and effective repair option for management of ureteral strictures.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2023.05.059</identifier><identifier>PMID: 37532087</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Constriction, Pathologic ; Cystoscopy ; Humans ; Male ; Urethra - surgery ; Urethral Stricture - etiology ; Urethral Stricture - surgery ; Urinary Bladder</subject><ispartof>Urology (Ridgewood, N.J.), 2023-11, Vol.181, p.e200-e203</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. 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Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture. 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subjects Constriction, Pathologic
Cystoscopy
Humans
Male
Urethra - surgery
Urethral Stricture - etiology
Urethral Stricture - surgery
Urinary Bladder
title Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture
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