Perineo-penile Degloving Exposure in Quartey s Urethroplasty: A Preliminary Report .

Objective: To present a technique of stricture exposure in Quartey s urethroplasty.Methods: A retrospective analysis of case files of seven patients that underwent perineo-penile degloving (PPD) exposure for Quartey s urethroplasty was done and formed the basis of this communication.The perineo-penile degloving exposure involves a midline perineal incision to expose the bulbar urethral and a circumcising incision to deglove the penis which is later delivered to the perineum through the retro-scrotal tunnel. The urethroplasty is then done in a single operation field.Results: Seven patients with long segment urethra stricture were repaired using PPD exposure during the study period. The age ranged from 35 to 70 years with a mean of 48.6±11.1 years. The peno-bulbar site was involved in six (85.7%) of the patients. The mean intra-operative length of the stricture is 7.6±1.5cm. All the patients had Quartey s flap for their reconstruction under spinal anaesthesia with mean operation time of 3.16±0.50 hours (range 2.30 – 4.00 hours). They all had ventral on-lay repair except for one patient who had tubularization of the flap and anastomosis. Three of the patients had excellent short-term outcome. However, one patient developed slight distal penile skin necrosis, two patients had perineal wound infection and one patient could not void despite patent urethra post- operatively. Of the patients, only one had extravasation of contrast on pericatheter urethrogram which warranted leaving the urethral catheter for one more week. The mean follow-up period was 8.3±4.5 months with a range of 3 to 14 months. There has being no evidence of recurrence clinically or urodynamically thus far.Conclusion: PPD is convenient and allows tension-free, water-tight reconstruction in a single operation field with a Conclusion: PPD is convenient comparable short-term outcome.