• Journal of Chest Surgery
• /
• v.18 no.3
• /
• pp.534-536
• /
• 1985

In a review of our cases presenting with urethral strictures, we noted a high incidence following open heart surgery. In an attempt to elucidate factors predisposing to the occurrence of urethral stricture, we studied the following data; preoperative laboratory study, aortic clamp time, dosage of heparin and protamine, degree of hypothermia, platelet count, and blood pressure. No significant differences were found between the stricture group and the non-stricture group. Of 33 patients admitted in our hospital with urethral stricture, 8 had suffered after open heart surgery. We believe that the urethral catheter is at least partly responsible for stricture formation. Associated factor, for example urethral ischemia, may be contributory.

• Archives of Plastic Surgery
• /
• v.39 no.3
• /
• pp.257-260
• /
• 2012

This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique.

• Journal of Veterinary Clinics
• /
• v.29 no.4
• /
• pp.331-333
• /
• 2012

A 2-year-old, castrated male domestic short-haired cat was presented with dysuria. The physical and radiographic examinations were revealed the urethral stricture and rectourethral fistula after perineal urethrostomy (PU). A prepubic urethrostomy was performed to resolve these problems. After the treatment, the cat had normal urination and complete wound healing without any complications. This is the first case report on co-occurrence of the urethral stricture and rectourethral fistula after PU in the cat.

• Archives of Reconstructive Microsurgery
• /
• v.10 no.2
• /
• pp.81-85
• /
• 2001

In the treatment of urethral stricture, many problems still remain with the current methods making it a field of further exploration for reconstructive surgeon. Furthermore, when total or multiple strictures of the penile urethra exist, the methods of surgery become difficult due to a necessity for a long neourethra. Introduction of vascularized free flap has broadened the choice and improved the results of reconstruction for the urethra. The authors used a sensate ulnar forearm free flap in a patient with multiple penile urethral strictures for reconstruction. Uroflowmetry, 30 months after surgery, revealed that maximal flow rate was 15.5 ml/sec, average flow rate was 9.5 ml/sec, and voided volume was 157 ml. A urethrogram was performed 30 months postoperatively and a good result was achieved. The ulnar forearm free flap used by the authors are thin and pliable and is good for providing sufficient length to reconstruct the neourethra for a long urethral defect.

• Archives of Plastic Surgery
• /
• v.39 no.3
• /
• pp.253-256
• /
• 2012

A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP) flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

• Journal of Yeungnam Medical Science
• /
• v.9 no.2
• /
• pp.416-421
• /
• 1992

Male urethral diverticulum is uncommon lesion, furthermore calculus formation within the male urethral diverticulum is very rare. Generally, urethral diverticula are classified as congenital and acquired. The majority of male urethral diverticula are acquired and approximately 10 to 20 per cent are congenital. Acquired urethral diverticula in the male may arise from many sources, including infection(prostatic abscess, infection of periurethral glands, hematoma or schistosomiasis), obstruction (stricutre, impacted stone, Cunningham clamp or condom catheter) and trauma(instrumentation, external injury and pelvic fracture). Calculi formation is more common in the acquired diverticulum owing to stagnation of urine and infection. These calculi in the diverticulum usually are solitary and may attain considerable size with predisposing factors. 1) a ureteral or bladder calculus that is lodged in the urethra, 2) urethral trauma or stricture, 3) calcification around a foreign body or hair. The treatment of urethral diverticulum conbined with stone is excision of the diverticula with removal of stone. We treated two cases of urethral diverticulum combined with stone in the male, and report with review of literature.

• Archives of Plastic Surgery
• /
• v.40 no.5
• /
• pp.584-588
• /
• 2013

Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.12
• /
• pp.208-212
• /
• 2017

A urinary calculus in the urethra is rarely seen and usually encountered in men with a urethral stricture or diverticulum. Herein, we report a rare case of a giant calculus in the urethra of a 42-year-old male patient with paraplegia after spinal cord injury due to car accident 20 years ago. A recent urologic consultation from the emergency room was performed since the patient had multidisciplinary symptoms during the day without any urination and presented with urinary difficulties due to hematuria and pain symptoms occurring with a mass in the bottom of the testicles. Abdomen and pelvic computed tomography (CT) was performed to examine the tumor mass, which was found to be absent. In addition, urethral stones were observed in the CT. Cystostomy was performed after the first urethroplasty, and the stone was removed from the urethra. Two weeks later, the patient was subjected to urethrography to remove the Foley catheter. No specific finding in voiding was detected. Giant urethral stones sometime require differentiation from tumor status. Treatment may vary according to size and location, requiring careful examination.

• Journal of Veterinary Clinics
• /
• v.16 no.2
• /
• pp.501-505
• /
• 1999

Two dogs were presented urinary disorder in the associated with urolithiasis. Clinical signs were increased frequency of urination with mild straining pollakiuria, general depression and anorexia. On physical examinations, the pain was revealed at the palpation of the urethral area. Urinalysis showed high specific gravity, high pH, and triple phosphates. Radiography showed an increased radiopacity, and ultrasonography showed hyperecho in the just behind of os penis. Urolithiasis was diagnosed on the basis of clinical signs, radiography, and ultrasonography. In the prescrotal urethrotomy, urethra on the midline was incised and uroliths were eliminated. After elimination of uroliths, incision area was closed with 4-0 synthetic absorbable suture. In postoperative, there was good prognosis without hemorrhage, inflammation, and urethral stricture.

• Archives of Plastic Surgery
• /
• v.47 no.6
• /
• pp.613-618
• /
• 2020

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.