Single stage urethroplasty using penile skin flaps

1. Single-Stage Urethroplasty
using different skin flaps
By
Mohammed A. Abdel-Rassoul, M.D., M.R.C.S., F.E.B.U.
Cairo University

2. Local Penile Flaps
Genital skin island flaps are mobilized on
dartos fascia of the penis
tunica dartos of the scrotum
In the past, these flap operations were considered separate
procedures.
All these procedures are different applications of a single
concept
Use the areas of redundant non-hirsute genital skin.

3. at least 2 cm in width to insure that the final caliber of the
reconstructed uretha is roughly 24 Fr assuming the urethral plate
is at least 0.5 cm to 1 cm in width.
One-stage tube grafts or flaps should be avoided ( low success and
durability.)
Flaps can be
ventral-transverse (for fossa strictures)
ventral-longitudinal (for the pendulous urethra)
transverse-circumferential (for all aspects of the
anterior urethra) and rotated to reach the defect.
Combined (Q-flap)
Local Penile Flaps

4. Proper mobilization will not put the flap on
tension or cause penile torsion.
keeping both the penis & flap on stretch avoids
the complications of sacculations and
diverticula.
Local Penile Flaps

5. Fossa Navicularis
stricture

7. Short penile stricture

25. Long penile stricture

27. Short bulbar stricture

29. Stricture involving the
Fossa Navicularis & penile urethra

45. Bulbo-penile stricture

47. Long stricture involving
Penile & Bulbar urethra

79. Pan-urethral Stricture

81. Thank you