Repair of Complicated Posterior Urethral Stricture Using Inferior Pubectomy and Gracilis Muscle Flap / 대한비뇨기과학회지

PURPOSE: To evaluate the usefulness of an inferior pubectomy and a gracilis muscle flap for the reconstruction of a complicated posterior urethral stricture, where urethroplasty had failed, or due to a long urethral defect. MATERIALS AND METHODS: A total of sixty eight patients with complicated posterior urethral strictures, following a pelvic bone fracture, were managed by a one-stage perineal repair at Pundang CHA hospital between March 1998 and April 2002. End-to-end anastomosis was performed in all cases, with corporeal body separation, or an inferior pubectomy and transposition of the gracilis muscle flap performed in a progressive manner if required. RESULTS: The success rate of all the cases was 95.6%. Additional procedures made no differences to the incidence of impotence, and the incidences of restricture and incontinence were low. CONCLUSIONS: Our results shows that an inferior pubectomy and a gracilis muscle flap can be useful methods in the treatment and prevention of incontinence and restricture in most cases of complicated posterior urethral strictures.

Clinical significance of corporeal body separation and inferior pubectomy in complex posterior urethral strictures / 대한비뇨기과학회지

A total of fifty three patients with posterior urethral strictures followed by pelvic bone fracture were managed by one-stage perineal repair at Pusan National University from Jan. 1985. to Jun 1992. End-to-end anastomosis was performed in all cases, but other procedures were added to accomplish tension-free anastomosis in 34 cases. These techniques, which included distal urethra mobilization, corporeal body separation and inferior pubectomy wore performed in a progressive manner as needed. Excellent results were achieved and success rate was 97.8 % of all cases. And we evaluate complications after such progressive maneuvers and the relationship between type of posterior urethral injury based on urethrography, the types of surgical procedure and the types of pelvic bone fractures. Additional procedure were attributed to severe initial type IV urethral injury, unstable pelvic bone fracture and complex urethral stricture. In spite of performing additional procedures, the incidence of impotence, restrictue and incontinence made no differences. Therefore, separation of corporeal bodies and inferior pubectomy are safe and efficient method to treat nearly almost cases of urethral strictures including complex urethral strictures.