Ulus Travma Acil Cerrahi Derg. 2014; 20(6): 427-431 | DOI: 10.5505/tjtes.2014.72537

Uzun segment üretral darlýklarda penil fasiyokutanöz flep üretroplasti

Ali Atan¹, Altuð Tuncel², Melih Balcý², Yýlmaz Aslan², Ersin Köseoðlu², Anýl Erkan^2
1Gazi Üniversitesi Týp Fakültesi, Üroloji Ana Bilim Dalý, Ankara
²Ankara Numune Eðitim Ve Araþtýrma Hastanesi, 3. Üroloji Kliniði, Ankara

AMAÇ: Uzun segment üretral darlýklarda penil fasyokutanöz flep üretroplastinin baþarýsýný incelemek.
GEREÇ VE YÖNTEM: Çalýþmamýza uzun segment üretral darlýðý olan 17 hasta alýndý. Darlýk segmentinin uzunluðuna göre, vertikal veya sirküler penil deri fasyokutanöz flep, 18 F üretral kateter üzerinden anastomoz edildi. Hastalar, üretral kateterin alýnmasýnýn ardýndan birinci haftada ve altýncý ayda üroflovmetri ve ultrasonografi eþliðinde yapýlan iþeme sonrasý rezidüel idrar hacmi ölçümleri ile deðerlendirildi.
BULGULAR: Hastalarýn ortalama yaþý 52 (17-67) yýl, ortalama takip süresi 60 (12-96) ay idi. Ortalama darlýk uzunluðu 105 (40-150) mm olarak saptandý. Vertikal ve sirküler penil fasyokutanöz flepler sýrasý ile dört ve 13 hasta için kullanýldý. Üretral kateterin alýnmasýnýn ardýndan birinci haftada yapýlan maksimum idrar akým hýzý ve iþeme sonrasý rezidüel idrar ölçümleri sýrasý ile 19.1 (9-31) ml/sn ve 12.9 (0 - 40) cm3 idi. Ayný parametreler ameliyat sonrasý altýncý ayda 17.4 (8-25) ve 15.2 (0-40) olarak ölçüldü.
TARTIÞMA: Uzun dönem sonuçlarýmýz penil fasyokutanöz flep üretroplastinin uzun segment üretral darlýklarda uygun bir tedavi seçeneði olduðunu göstermektedir.

Anahtar Kelimeler: Üretroplasti, penil fasiyokutanöz flep; tedavi; baþarý.

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Penile fasciocutaneous flap urethroplasty in long segment urethral stricture

Ali Atan¹, Altuð Tuncel², Melih Balcý², Yýlmaz Aslan², Ersin Köseoðlu², Anýl Erkan^2
1Gazi University School Of Medicine, Department Of Urology, Ankara, Turkey
²Ankara Numune Research And Training Hospital, Third Department Of Urology, Ankara, Turkey

Background: To evaluate the succes of penil fasciocutaneous flap urethroplasty in treatment of long segment urethral stricture.
Methods: In this study, 17 patients with long segment urethral stricture were included. According to lenght of the narrow segment, vertical or circular penile skin fasciocutaneous flap was anastomosed on 18 F urethral catheter. In first week and 6th month after removal of urethral catheter, patients were controlled by uroflowmetry and postvoiding residual urine volume measurement by ultrasound.
Results: The mean age of the patients were 52 (range; 17 to 67) years. The mean follow up-time was 60 (12-96) months. Mean length of stricture was 105 (40-150) mm. Vertical and circular penile fasciocutaneous flaps were used in 4 and 13 patients, respectively. Maximum urine flow rate and postvoiding residual urine assessment in first week after removal of urethral catheter were 19.1 (range; 9 to 31) ml/s and 12.9 (range; 0 to 40) cm3, respectively. Same parameters in postoperative 6th months were 17.4 (range; 8 to 25) ml/s and 15.2 (range; 0 to 40) cm3 respectively.
Conclusion: Our long term results showed that penile fasciocutaneous flap urethroplasty method seems to be a reasonable treatment option in treatment of long segment urethral stricture.

Keywords: Urethroplasty, penil fasciocutaneous flap, treatment, success

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ATIF KOPYALA