//Small intestinal submucosa (sis) graft urethroplasty: short-term results
Small intestinal submucosa (sis) graft urethroplasty: short-term results 2017-04-05T18:51:39+00:00

Small intestinal submucosa (sis) graft urethroplasty: short-term results

 

Uretra, stenosi uretrale

Authors:
Enzo Palminteri, Elisa Berdondini, et Al.

Publication:
Eur. Urology 2007

Volume:
1(6):1695-1701; discussion 1701. Epub 2006 Dec 18.

Centre:
Center for Urethral and Genitalia Reconstructiue Surgery, Arezzo, Italy.

 

Objective
We evaluated the use of small intestinal submucosa (SIS) graft in penile and bulbar urethroplasties.

Methods
From 2003 to 2004, 20 men (mean age, 41 yr) with anterior urethral strictures underwent urethroplasty using SIS (COOK) as an inlay or onlay patch graft. Stricture location was penile in 1 patient, bulbar in 16, and penile-bulbar in 3. Average stricture and graft lengths were 3 and 5.7 cm, respectively. A dorsal inlay graft was performed in 14 cases, ventral onlay graft in 1, and dorsal inlay plus ventral onlay in 5. Clinical outcome was considered successful if no postoperative procedure was needed.

Results
Mean follow-up period was 21 mo (range: 13-35 mo). Seventeen cases (85%) were successful and 3 (15%) were failures. No postoperative complications were related to the use of heterologous graft material, such as infection or rejection. Sixteen successes (94%) were bulbar repairs and one a penile-bulbar repair, with stricture and graft average lengths 2.6 and 5.35 cm, respectively. Cystoscopy at 3 mo revealed adequate calibre lumens, but SIS grafted areas were not completely replaced by urothelium. The three failures were penile and penile-bulbar urethral repairs with stricture and graft average lengths of 5.7 and 7.7 cm, respectively. Recurrences showed fibrous tissue involving the grafted area with extension into the penile and bulbar urethra.

Conclusions
In our short-term results, SIS seems to be a versatile material that may have a role in select urethral reconstructions. Longer follow-up and further investigations in select patients are needed before widespread use is advocated.

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