Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures

Objective: To prospectively evaluate the feasibility and initial results of an everted saphenous vein graft (eSVG) as a dorsolateral onlay, in patients with long anterior urethral strictures and/or chronic tobacco users. Patients and methods: In all, 20 patients with long anterior urethral stricture...

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Autores principales:	Arif Akhtar, Nikhil Khattar, Hemant Goel, Swatantra Rao, Raman Tanwar, Rajeev Sood
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2017
Materias:	Long anterior urethral stricture Lichen sclerosis Dorsolateral onlay Everted saphenous vein graft substitution urethroplasty Tobacco Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/4271a092765f4c38887d88a2a398630c
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spelling	oai:doaj.org-article:4271a092765f4c38887d88a2a398630c2021-12-02T10:04:12ZLooking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures2090-598X10.1016/j.aju.2017.06.003https://doaj.org/article/4271a092765f4c38887d88a2a398630c2017-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X17300748https://doaj.org/toc/2090-598XObjective: To prospectively evaluate the feasibility and initial results of an everted saphenous vein graft (eSVG) as a dorsolateral onlay, in patients with long anterior urethral strictures and/or chronic tobacco users. Patients and methods: In all, 20 patients with long anterior urethral strictures (>7 cm) and/or chronic tobacco exposed oral mucosa were included in the study. The harvested SVG was hydro-distended, detubularised, and everted. Substitution urethroplasty using an eSVG was performed using a dorsolateral onlay technique. Symptoms were assessed using the International Prostate Symptom Score (IPSS) and uroflowmetry at 1, 3 and 6 months; and voiding and retrograde urethrograms, and urethroscopy were done at 3 months. Failure was defined as failure to void, need for interventions in form of direct-vision internal urethrotomy or endodilatation. Results: Three patients were excluded because they underwent a staged urethroplasty. In all, 17 patients underwent eSVG substitution urethroplasty. The mean (SD, range) follow-up of our patients was 17.64 (5.23, 10–26) months. The mean (SD, range) length of the strictured segment was 14 (2.5, 10–18) cm and the length of the harvested SVG was 16.3 (2.7, 12–20) cm. The mean (SD) IPSS at 1, 3 and 6 months after catheter removal was 10 (2.8), 10 (3.4) and 10 (1.4) and the quality-of-life score was 1.76 (0.5), 2.05 (1.0) and 2.05 (1.0), respectively. Postoperatively, endodilatation was required in two patients. Complete failure occurred in one patient. Conclusions: An eSVG, as a dorsolateral onlay graft, is a promising and prudent option for long anterior urethral strictures, especially in patients with poor oral hygiene and chronic tobacco use.Arif AkhtarNikhil KhattarHemant GoelSwatantra RaoRaman TanwarRajeev SoodTaylor & Francis GrouparticleLong anterior urethral strictureLichen sclerosisDorsolateral onlayEverted saphenous vein graft substitution urethroplastyTobaccoDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 15, Iss 3, Pp 228-235 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Long anterior urethral stricture Lichen sclerosis Dorsolateral onlay Everted saphenous vein graft substitution urethroplasty Tobacco Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Long anterior urethral stricture Lichen sclerosis Dorsolateral onlay Everted saphenous vein graft substitution urethroplasty Tobacco Diseases of the genitourinary system. Urology RC870-923 Arif Akhtar Nikhil Khattar Hemant Goel Swatantra Rao Raman Tanwar Rajeev Sood Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures
description	Objective: To prospectively evaluate the feasibility and initial results of an everted saphenous vein graft (eSVG) as a dorsolateral onlay, in patients with long anterior urethral strictures and/or chronic tobacco users. Patients and methods: In all, 20 patients with long anterior urethral strictures (>7 cm) and/or chronic tobacco exposed oral mucosa were included in the study. The harvested SVG was hydro-distended, detubularised, and everted. Substitution urethroplasty using an eSVG was performed using a dorsolateral onlay technique. Symptoms were assessed using the International Prostate Symptom Score (IPSS) and uroflowmetry at 1, 3 and 6 months; and voiding and retrograde urethrograms, and urethroscopy were done at 3 months. Failure was defined as failure to void, need for interventions in form of direct-vision internal urethrotomy or endodilatation. Results: Three patients were excluded because they underwent a staged urethroplasty. In all, 17 patients underwent eSVG substitution urethroplasty. The mean (SD, range) follow-up of our patients was 17.64 (5.23, 10–26) months. The mean (SD, range) length of the strictured segment was 14 (2.5, 10–18) cm and the length of the harvested SVG was 16.3 (2.7, 12–20) cm. The mean (SD) IPSS at 1, 3 and 6 months after catheter removal was 10 (2.8), 10 (3.4) and 10 (1.4) and the quality-of-life score was 1.76 (0.5), 2.05 (1.0) and 2.05 (1.0), respectively. Postoperatively, endodilatation was required in two patients. Complete failure occurred in one patient. Conclusions: An eSVG, as a dorsolateral onlay graft, is a promising and prudent option for long anterior urethral strictures, especially in patients with poor oral hygiene and chronic tobacco use.
format	article
author	Arif Akhtar Nikhil Khattar Hemant Goel Swatantra Rao Raman Tanwar Rajeev Sood
author_facet	Arif Akhtar Nikhil Khattar Hemant Goel Swatantra Rao Raman Tanwar Rajeev Sood
author_sort	Arif Akhtar
title	Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures
title_short	Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures
title_full	Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures
title_fullStr	Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures
title_full_unstemmed	Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures
title_sort	looking beyond oral mucosa: initial results of everted saphenous vein graft urethroplasty (esvgu) in long anterior urethral strictures
publisher	Taylor & Francis Group
publishDate	2017
url	https://doaj.org/article/4271a092765f4c38887d88a2a398630c
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Looking beyond oral mucosa: Initial results of everted saphenous vein graft urethroplasty (eSVGU) in long anterior urethral strictures

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