Introduction of surgical techniques at the Karl Heusner Memorial Hospital in patients with urethral stricture

Abstract

The treatment of urethral stenosis in adults is a challenge for the urologist and constitutes a urological disease with significant morbidity. Worldwide, the most common causes are those associated with iatrogenesis; approximately half of urethral stricture cases are treated with urethroplasty. The etiology is significantly different in younger patients compared to older patients, as well
as the site of stenosis. The therapeutic options range from urethral dilations, endoscopic internal urethrotomy, surgeries (terminal
term urethroplasty and substitution procedures) using various tissues including genital skin, extragenital skin, bladder mucosa
and buccal mucosa. Two clinical cases attended in the urology department of the Karl Heusner Memorial Hospital are presented. A
patient with a diagnosis of urethral stenosis, previously treated with periodic urethral dilations, on whom a terminal term urethroplasty was performed, subsequently requiring internal urethrotomy for scar fibrosis at the site of anastomosis. The other patient had a diagnosis of genital sepsis, leading to a sequel of posterior urethral necrosis of 9cm. A graft of oral mucosa (urethroplasty with a flap of buccal mucosa) was carried out in a single surgical time. In the patient, the donor area was the buccal mucosa, achieving total reconstruction of the affected urethra. The usefulness of this mucosa in the surgical reconstruction of complex urethral conditions, due to its immunological benefits, being less prone to infections and recurrences, with good aesthetic and functional results is highlighted.