RESUMO
We'd like to present our experience in treating long [>5 cm] anterior urethral stricture by penile skin flap as dorsal on-lay in one-stage procedure. Between January 1998 and December 2010, 18 patients [aged from 28-65 years] presented with long urethral stricture, 5.6-13.2 cm, [penile in 6, bulbar in 2, and combined in 10 cases], those were repaired utilizing long penile skin flaps placed as dorsal on-lay flap in one-stage [Orandi flap 6 cm in 6 cases, circular flaps 7-10 cm in 8, and spiral flaps 10-15 cm in 4]. Uroflowmetry and RUG were done following catheter removal and at 6 and 12 months. The urethral patency was achieved in 77% of patients. The complications were fistula in 1 patient [5.5%], re-stricture occurred in 3 patients [16.6%] that required visual internal urethrotomy [VIU], and 2 patients [11%] showed curvature on erection that did not interfere with sexual intercourse. Diverticulum [penile urethra] was seen in 1 patient [5.5%] containing stones and was excised surgically. There was penile skin loss in 3 patients [16.6%]. All patients completed at least one year follow-up period. Free penile skin flaps offer good results [functional and cosmetic] in long anterior urethral stricture. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.