Tunica Vaginalis Pedicle Flap Substitution Urethroplasty for Reconstruction of Anterior Urethral Stricture

Authors

  • Moktadir Hossain Mridha Assist Register, Department of Surgery, Shahid M Monsur Ali Medical College, Sirajgonj, Bangladesh.
  • Mohammad Shah Alam Resident Surgeon, Urology Sher-E-Bangla Medical College Hospital, Barisal, Bangladesh.
  • Md Maidul Islam Medical officer, Dept. of Urology, Rangpur medical College hospital, Rangpur, Bangladesh.
  • Md Ali Ashraf Assistant Registrar, Dhaka Medical College Hospital, Dhaka, Bangladesh.
  • K M Faisal Al Ahsan Resident Surgeon, 250 Beded General Hospital, Brahmanbaria, Bangladesh.
  • Amiya Dev Bhatta Assistant Registrar, Department of Surgery Shaheed M. Mansur Ali Medical College Hospital, Sirajganj, Bangladesh.
  • A K M Anwarul Islam Clinical Fellow in Urology (WHO) Ex-Chairman, Department of Urology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

DOI:

https://doi.org/10.3329/kyamcj.v14i02.68563

Keywords:

Tunica Vaginalis Pedicle Flap, Urethoplasty, Maximus flow rate (Qmax), International prostatic Symptom Index (IPSS), Post Void residual urine (PVR)

Abstract

Background: In long-segment urethral stricture, substitutional urethroplasty is the best option to get long-term good results. Though buccal mucosa is the most widely used tissue, it has limitations in some oral pathology. In several publications, there is evidence that Tunica vaginalis can be used as a graft or flap to reconstruct fibrotic urethra as well as to provide a vascularized covering to prevent subsequent urethrocutaneous fistula formation. This study evaluated the efficacy of the tunica vaginalis pedicle flap’s efficacy for managing anterior urethral stricture.
Objectives: To evaluate the clinical efficacy of tunica vaginalis pedicle flap for reconstruction of anterior urethral stricture by assessing change in the maximum flow rate (Qmax), International prostatic symptom index (IPSS), postvoid residual urine (PVR) from baseline and the complication of surgery.
Materials and Methods: This was a prospective clinical trial conducted in the Department of Urology, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2017 to June 2018. A total of 15 patients were selected from the study population according to inclusion and exclusion criteria. The standard operation technique of urethroplasty by tunica vaginalis flap was followed. Patients were followed up after 3 months & 6 months to evaluate IPPS score, Qmax, flow time, PVR, and complications.
Results: The mean age and stricture length of study participants were 38.93±11.38 years and 3.55±1.05 cm. The maximum flow of urine was 15.844±3.80 ml/sec at the final follow up which showed statistically significant improvement from baseline. There was also a significant improvement in IPSS, and quality of life during follow-up. Flow time and post-void residue reduced significantly from preoperative measurement. A total of 4 patients developed complications after the substitution of urethroplasty with tunica vaginalis.
Conclusion: Tunica vaginalis pedicle flap may be an effective choice in the reconstruction of anterior urethral stricture.

KYAMC Journal Vol. 14, No. 02, July 2023: 79-82.

Downloads

Download data is not yet available.
Abstract
117
PDF
92

Downloads

Published

2023-10-10

How to Cite

Moktadir Hossain Mridha, Mohammad Shah Alam, Md Maidul Islam, Md Ali Ashraf, K M Faisal Al Ahsan, Amiya Dev Bhatta, & A K M Anwarul Islam. (2023). Tunica Vaginalis Pedicle Flap Substitution Urethroplasty for Reconstruction of Anterior Urethral Stricture. KYAMC Journal, 14(02), 79–82. https://doi.org/10.3329/kyamcj.v14i02.68563

Issue

Section

Original Articles