World Journal of Urology

, Volume 16, Issue 3, pp 175–180

Current controversies in anterior urethral stricture repair: free-graft versus pedicled skin-flap reconstruction

  • Hunter Wessells
  • Jack W. McAninch

DOI: 10.1007/s003450050048

Cite this article as:
Wessells, H. & McAninch, J. World J Urol (1998) 16: 175. doi:10.1007/s003450050048


Reconstruction of long anterior urethral strictures that cannot be excised and reanastomosed remains controversial. We critically reviewed the literature on free-graft and pedicled skin-flap urethroplasty to determine the optimal method of repair. Overall, free grafts were successful in 84.3% of cases and flaps, in 85.9%. Buccal mucosa grafts are the most successful method for reconstruction of bulbar urethral strictures. For strictures in the penile urethral or a compromised graft bed a distal penile skin flap is the most reliable and tested approach. Dorsal free-graft urethroplasty may be considered when penile skin deficiency prevents use of a flap. For the most complex strictures, in which a flap is not possible and the graft bed is of poor quality, a mesh graft in two stages may be the only option. Thus, for reconstruction of complex anterior urethral strictures, both free-graft and flap procedures remain indispensable.

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • Hunter Wessells
    • 1
  • Jack W. McAninch
    • 2
  1. 1.Section of Urology, University of Arizona, P.O. Box 245077, Tucson, AZ 85724-5077, USA Tel.: +1-520-626-2016; Fax: +1-520-626-4933 e-mail: hwessell@u.arizona.eduUS
  2. 2.Department of Urology, University of California School of Medicine, San Francisco, California, USAUS

Personalised recommendations