Publication:

Use of transverse penile fasciocutaneous flap in management of long segment anterior urethral stricture at the Jos university teaching hospital, Jos Nigeria

Background Urethral stricture may be defined as a narrowing of the lumen of the urethra due to scar tissue formation. It results from fibrosis and loss of compliance of the urethra leading to bladder outlet obstruction. Treatment of long segment urethral stricture is a huge challenge to the reconstructive Urologist. This study is to determine the aetiology of long segment urethral stricture, location of the stricture, use of distal transverse penile fasciocutaneous flap and the complications associated with the use of the flap.

Methods Twenty two patients with long segment anterior urethral stricture from 2014 to 2017 at the Jos University teaching hospital were included in the study. Patient assessment included complete history including past interventions for the urethral stricture disease, physical examination and radiological examination. Patient’s age, aetiology of stricture, stricture length, location of stricture, surgical management and complications were recorded.

Results Twenty two consecutive patients were involved in the study. The mean age was 48.8years with a range of 35 to 70 years. Post infection accounted for 64% of the strictures while catheter induced inflammatory stricture accounted for 36%. The mean length of the stricture was 9.4cm, with a range of 5cm to 15cm. Penile fasciocutaneous flap was used in all the repairs. Overall complication was 27.3%.

Conclusions Transverse penile fasciocutaneous flap is a well-vascularized pedicle and skin island. It is mobile and can be adapted to repair long segment anterior urethral strictures. Surgical complications include ring stenosis, penile skin necrosis and urethrocutaneous fistula.