Modified one-stage dorsal-inlay buccal mucosa graft technique for ventral penile urethral and penile skin erosion: A step-by-step guide.

Arab J Urol

Faculty of Medicine and Health science, University of Antwerp, Antwerp, Belgium; Department of Urology, Antwerp University Hospital, Antwerp, Belgium.

Published: December 2016

Objective: To demonstrate the use of a modified single-stage technique for the repair of a ventral penile urethral erosion with involvement of the penile skin, as penile urethral erosion is a rare but potential complication of chronic indwelling catheterisation with a lack of available recommendations for reconstructive options.

Patient And Methods: A 44-year-old male with paraplegia, neurogenic bladder dysfunction and chronic sacral decubitus, presented with a large mid-penile erosion of the ventral penile shaft and urethra, which was caused by chronic transurethral indwelling catheterisation while being hospitalised in an intensive care unit. The reconstruction involved a single-stage dorsal-inlay buccal mucosa graft urethroplasty (Asopa) in addition to the second stage of a two-stage urethroplasty. The urethroplasty as well as the buccal mucosa graft harvest were performed by a single team.

Results: The modified single-stage urethroplasty procedure had a duration of 158 min with a postoperative hospitalisation of 3 days. At 8-months follow-up, the lesion had fully healed and the patient was back on clean intermittent self-catheterisation with solifenacin 10 mg daily. No complications occurred postoperatively.

Conclusion: The modified single-stage dorsal-inlay technique is a viable method for repairing ventral penile urethral erosion with involvement of penile skin.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122800PMC
http://dx.doi.org/10.1016/j.aju.2016.08.003DOI Listing

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