Glans tunnel‐based reconstruction with skin flap or lip mucosa graft for distal penile urethral strictures

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Main Authors: Fuhao Ji, Lin Wang, Tong Zhao, Yidong Liu, Xiangguo Lyu
Format: Artículo Open Access
Published: Wiley 2025
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author Fuhao Ji
Lin Wang
Tong Zhao
Yidong Liu
Xiangguo Lyu
author_facet Fuhao Ji
Lin Wang
Tong Zhao
Yidong Liu
Xiangguo Lyu
Fuhao Ji
Lin Wang
Tong Zhao
Yidong Liu
Xiangguo Lyu
collection Wiley Open Access
contents Glans tunnel‐based reconstruction with skin flap or lip mucosa graft for distal penile urethral strictures Fuhao Ji Lin Wang Tong Zhao Yidong Liu Xiangguo Lyu BJUI Compass Abstract Purpose The aim of this study is to evaluate the clinical efficacy of glans tunnel urethroplasty using a pedicled penile flap or lower lip mucosa for glans penis urethral stricture. Methods A retrospective analysis was conducted on 41 patients with urethral stricture at the glans penis who visited our hospital from January 2021 to July 2025. Causes include iatrogenic factors (including prostate hyperplasia surgery, transurethral resection of bladder lesions and catheterisation), a history of hypospadias repair and penile lichen sclerosus (LS), including 14 cases of urethral meatus stricture and 27 cases of navicular fossa stricture. The length of the stricture was 2.0 (1.0, 3.0) cm, the maximum flow rate ( Q max ) was (7.24 ± 3.47) ml/s, the International Prostate Symptom Score (IPSS) was (17.49 ± 5.29), and the International Index of Erectile Function ‐ 5 (IIEF‐5) was 14.0 (9.00, 21.00) points. Surgery preserved glans integrity, incised the ventral stenotic urethra and reconstructed the defect with a flap or mucosa graft. A F16/18 indwelling catheter was removed after 3 weeks. Pre‐ and post‐operative uroflowmetry, IPSS and IIEF‐5 evaluations were conducted. Results All post‐operative outcomes were assessed at 12–23 months (median 20, IQR 19–21). Postoperative Q max increased to 23.61 ± 4.54 ml/s, and the IPSS decreased to 9.02 ± 3.57 (both P  < 0.001 vs. pre‐op). The IIEF‐5 score (14.71 ± 6.48) points showed no significant change. No recurrence, glans dehiscence, fistula, infection or ischaemia occurred. Conclusions Glans tunnel urethroplasty maintaining glans integrity effectively treats urethral meatal and navicular fossa strictures, balancing function and aesthetics. 10.1002/bco2.70097 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/bco2.70097
format Artículo Open Access
id wiley_oa_10_1002_bco2_70097
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2025
publisher Wiley
record_format wiley_oa
spellingShingle Glans tunnel‐based reconstruction with skin flap or lip mucosa graft for distal penile urethral strictures
Fuhao Ji
Lin Wang
Tong Zhao
Yidong Liu
Xiangguo Lyu
BJUI Compass
Glans tunnel‐based reconstruction with skin flap or lip mucosa graft for distal penile urethral strictures Fuhao Ji Lin Wang Tong Zhao Yidong Liu Xiangguo Lyu BJUI Compass Abstract Purpose The aim of this study is to evaluate the clinical efficacy of glans tunnel urethroplasty using a pedicled penile flap or lower lip mucosa for glans penis urethral stricture. Methods A retrospective analysis was conducted on 41 patients with urethral stricture at the glans penis who visited our hospital from January 2021 to July 2025. Causes include iatrogenic factors (including prostate hyperplasia surgery, transurethral resection of bladder lesions and catheterisation), a history of hypospadias repair and penile lichen sclerosus (LS), including 14 cases of urethral meatus stricture and 27 cases of navicular fossa stricture. The length of the stricture was 2.0 (1.0, 3.0) cm, the maximum flow rate ( Q max ) was (7.24 ± 3.47) ml/s, the International Prostate Symptom Score (IPSS) was (17.49 ± 5.29), and the International Index of Erectile Function ‐ 5 (IIEF‐5) was 14.0 (9.00, 21.00) points. Surgery preserved glans integrity, incised the ventral stenotic urethra and reconstructed the defect with a flap or mucosa graft. A F16/18 indwelling catheter was removed after 3 weeks. Pre‐ and post‐operative uroflowmetry, IPSS and IIEF‐5 evaluations were conducted. Results All post‐operative outcomes were assessed at 12–23 months (median 20, IQR 19–21). Postoperative Q max increased to 23.61 ± 4.54 ml/s, and the IPSS decreased to 9.02 ± 3.57 (both P  < 0.001 vs. pre‐op). The IIEF‐5 score (14.71 ± 6.48) points showed no significant change. No recurrence, glans dehiscence, fistula, infection or ischaemia occurred. Conclusions Glans tunnel urethroplasty maintaining glans integrity effectively treats urethral meatal and navicular fossa strictures, balancing function and aesthetics. 10.1002/bco2.70097 http://creativecommons.org/licenses/by/4.0/
title Glans tunnel‐based reconstruction with skin flap or lip mucosa graft for distal penile urethral strictures
topic BJUI Compass
url https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.70097