Meshgraft urethroplasty

Summary

Repeated stricture formation of the urethra, especially after multiple previous operations, as well as long strictures in paraplegic patients almost completely obliterating the urethra cannot be adequately treated by an one-stage operation. Successful results are equally difficult to obtain in those cases requiring complete resection of the urethra, such as occur with chronic infection with long fibrous strictures or in stone or abscess formation. Since 1977, we have been using a two-stage operative technique in which free, meshed foreskin or split-skin is grafted in the first session and the urethra is reconstructed in the second. A total of 83 patients with strictures in the distal and proximal urethra were treated with this two-stage procedure. In 82 patients, excellent anatomic and functional results were achieved; only one patient developed a recurrent stricture. This technique is most useful in difficult situations, such as restricturization following repeated endourethral operations, in exceedingly long strictures associated with chronic infection of the paraurethral tissue and in problematic strictures in paraplegic patients. It is shown here that this two-stage operative technique is a reliable and successful method for the treatment of even the most difficult urethral strictures.