Urethroplasty with split thickness skin grafts
Baudenbacher, R.; Steiner, A.
Der Urologe. Ausg. a 19(1): 41-46
1980
ISSN/ISBN: 0340-2592 PMID: 6986703 Document Number: 161517
At the Albert Schweitzer Hospital in Lambarene [Gabon], a high incidence of postgonorrhoic urethral strictures was observed. Acute gonorrhoical infection is seldom seen among the male patients. Most patients are seeking medical help at a late stage of the disease, sometimes with complete occlusion and multiple perineal and scrotal fistulae or abscesses. These cases are 1st treated by suprapubic cystostomy, abscess drainage and/or local debridement and systemic antibiotics. After healing of the acute inflammatory process perineal and scrotal induration and multiple skin scars may persist, leaving no possibility for any plastic urethal procedure using scrotal or perineal skin. The strictured or even destroyed part of the urethra of 3-5 cm length may be reconstructed with a thick split thickness skin graft from the thigh. The postoperative observation time is 4-20 mo. Urethrographic control was made in 13 patients 6-8 wk after the reconstruction. It showed a good early result in all cases. Due to the different circumstances (mentality, lack of motivation of the patient, long distances etc.) the late results can be judged only subjectively based on the micturition. The 14 plastic urethral reconstructions gave 7 good and 7 bad results. Early recurrence of the urethral stricture is due to the chronic infections within the paraurethral and perineal tissue, as well as due to the gonorrhoic recurrent infections after the operation.