AI Article Synopsis
- Meatal stenosis and fossa navicularis strictures are often caused by lichen sclerosus and surgical procedures, and a new graft technique was evaluated for their reconstruction.
- This study involved 26 patients who underwent a specific surgical method, focusing on preserving the glans cap and using a dorsal inlay graft, with patients monitored for symptom relief and urinary function post-surgery.
- Results indicated that while there were a few complications, most patients experienced significant improvements in symptoms and urinary flow after the procedure, making this technique a promising option for managing these conditions.
Article Abstract
Introduction: Meatal stenosis and fossa navicularis strictures (FNSs) are commonly caused by lichen sclerosus and instrumentation. We present the technique and short-term functional outcomes of glans cap-preserving dorsal inlay-free graft augmentation for the reconstruction of meatal stenosis and FNS.
Methods: This retrospective study analyzed patients with meatal stenosis and FNS who underwent glans cap-preserving dorsal inlay-free graft augmentation at our institute since 2019. The surgical technique included a ventral subcoronal approach, preservation and mobilization of the glans cap, a ventral midline urethrotomy incision over the stricture, and a dorsal midline meatotomy incision extending to the proximal normal urethral mucosa at the fossa navicularis, followed by dorsal inlay graft augmentation. During the follow-up, patients were periodically assessed for symptom scores, urinary flow rates (UFRs), and patient-reported outcomes.
Results: A total of 26 patients with a mean age of 45 ± 15 years were assessed. The predominant cause of stricture was lichen sclerosus ( = 15; 58%). The mean stricture length was 3.8 ± 0.5 cm, 73% had a circumcised phallus, and an oral mucosa graft augmentation was performed in 22 (85%) patients. Notable postoperative complications included intractable meatal hemorrhage ( = 1) and glans suture granuloma ( = 1), which required intervention. At a mean follow-up of 40 months, there were four failures, of which one patient required redo-urethroplasty. The remaining patients ( = 22; 85%) showed improved symptom scores ( < 0.05), UFRs ( < 0.05), and satisfactory patient-reported outcomes.
Conclusion: Glans cap-preserving dorsal inlay-free graft augmentation is a safe and feasible technique with satisfactory short-term functional outcomes for the management of meatal stenosis and FNS in carefully selected patients.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11296588 | PMC |
| http://dx.doi.org/10.4103/iju.iju_61_24 | DOI Listing |
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