Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Urethroplasty of extensive penile urethral strictures with a longitudinal ventral tubed flap of penile skin (modified Orandi urethroplasty): 20 years of follow-up of two cases

  • Heo, Jae Won (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Hong, Woo Taik (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Yong Hun (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Yang, Chae Eun (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Jiye (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Kim, Sug Won (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine)
  • Received : 2019.07.24
  • Accepted : 2020.06.15
  • Published : 2020.11.15
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Abstract

The surgical treatment of extensive urethral strictures remains a controversial topic; although techniques have evolved, there is still no definite method of choice. Since 1968, when Orandi presented an original technique for one-stage urethroplasty using a penile skin flap, the Orandi technique has become the most prevalently used one-stage procedure for anterior urethral strictures. We present a 20-year follow-up experience with one-stage reconstruction of long urethral strictures using a longitudinal ventral tubed flap of penile skin, with some important technical changes to Orandi's original technique to overcome the deficient vascularity caused by periurethral scar tissue. In 1997, a 55-year-old male patient complained of severe voiding difficulty and a weak urinary stream because of transurethral resection of the prostate due to benign prostatic hyperplasia. Another 47-year-old male patient had the same problem due to self-removal of a Foley catheter in 2002. In both patients, a urethrogram demonstrated extensive strictures involving the long segment of the anterior urethra. A rectangular skin flap on the ventral surface of the penis was used considering the appropriate length, diameter, and depth of the neourethra. The modified Orandi flap provided a pedicled strip of penile skin measuring an average of 8 cm. The mean duration of follow-up was 20.5 years. A long-term evaluation revealed stable performance characteristics without any complications.

Keywords

References

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