
URETROPLASTIA DORSAL SEGÚN TECNICA DE BARBAGLI. ANALISIS DE RESULTADOS Y FACTORES DE ÉXITO
Cristobal Marchal, Juan Enrique Pérez, Bernardo Herrera, Felipe Saez, Elisabeth Castillo, Francisco Antuña, Emilio Julve, Francisco Javier Machuca
URETROPLASTIA DORSAL SEGÚN TECNICA DE BARBAGLI. ANALISIS DE RESULTADOS Y FACTORES DE ÉXITO
OBJECTIVES: Dorsal urethroplasty as described by Barbagli has gained wide acceptance in the treatment of urethral stricture, given the simplification afforded by obtaining a free graft versus a flap.We present a series of 50 patients treated in our de-partment of urethral stricture by dorsal onlay free graft urethroplasty (Barbagli’s technique), in combination or not to other techniques in more complex strictures.METHODS: The average age of patients was 48.8 years (23-77), the mean follow up 42.9 months (12-96) and the most frequently observed etiology has been the inflammatory urethral stricture (50%).RESULTS: Overall success rate was 82% (41 cases) and failure 18% (9 cases). In the longer follow-up group, there was a slight drop in success rate of 80% (24 ca-ses) without any significant differences between groups (p= 0.98).Analyzing the variables length of free graft (p= 0.50, p> 36= 0.53), age (p= 0.12, p>36= 0.59), etiology of stricture (p= 0.77, p>36 = 0.77) and type of graft used (p=0.24, p>36= 0.38) did not show any influence on the final outcome of surgery, both in the total sample and the subgroup with follow-up > 36 months.The location of the stricture in bulbar urethra has shown better functional outcome than those operated on for stric-tures affecting also other urethral locations (p= 0.001) maintaining that result in the group of longer follow up (p>36= 0,001).The lack of treatment prior to urethral surgery has influen-ced the success of it, since 90.6% of patients without prior treatment before urethroplasty have seen a good func-tional outcome, compared to treatment prior to surgery that obtained a 66.7% (p= 0.03). This significance is also demonstrated in the group of follow-up > 36 months (p>36= 0.01).CONCLUSION: The dorsal onlay free graft urethroplas-ty is a versatile and reproducible technique with accep-table results which allows combination with other tech-niques when the stenosis extends to the penile urethra. In exceptional cases of panurethral strictures secondary to lichen sclerosus when there is no significant spongiofi-brosis and an acceptable urethral plate, can be applied to the whole urethra.
Uretral stricture / Dorsal onlay free graft / Barbagli’s technique {{custom_keyword}} /
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