Use of transverse penile fasciocutaneous flap in management of long segment anterior urethral stricture at the Jos university teaching hospital, Jos Nigeria

Chimaobi G. Ofoha, Samaila I. Shu’aibu, Victor E. Onowa, Zingkur Z. Galam, Nuhu K. Dakum


Background: Urethral stricture may be defined as a narrowing of the lumen of the urethra due to scar tissue formation. It results from fibrosis and loss of compliance of the urethra leading to bladder outlet obstruction. Treatment of long segment urethral stricture is a huge challenge to the reconstructive Urologist. This study is to determine the aetiology of long segment urethral stricture, location of the stricture, use of distal transverse penile fasciocutaneous flap and the complications associated with the use of the flap.

Methods: Twenty two patients with long segment anterior urethral stricture from 2014 to 2017 at the Jos University teaching hospital were included in the study. Patient assessment included complete history including past interventions for the urethral stricture disease, physical examination and radiological examination. Patient’s age, aetiology of stricture, stricture length, location of stricture, surgical management and complications were recorded.

Results: Twenty two consecutive patients were involved in the study. The mean age was 48.8years with a range of 35 to 70 years. Post infection accounted for 64% of the strictures while catheter induced inflammatory stricture accounted for 36%. The mean length of the stricture was 9.4cm, with a range of 5cm to 15cm. Penile fasciocutaneous flap was used in all the repairs. Overall complication was 27.3%.

Conclusions: Transverse penile fasciocutaneous flap is a well-vascularized pedicle and skin island. It is mobile and can be adapted to repair long segment anterior urethral strictures. Surgical complications include ring stenosis, penile skin necrosis and urethrocutaneous fistula.


Anterior, Complications, Long segment, Transverse penile flap, Urethral stricture

Full Text:



Temple CO, Vincent OO, Edwin O. The changing pattern of urethral stricture disease in Mid-western Nigeria. JMBR. A peer-review J Biomed Sci. 2006:5(2):50-4.

Lumen N, Hoebeke P, Willemsen P, De Taylor B, Pieters R, Oosterlinck W. Etiology of urethral stricture disease in the 21st century. J Urology. 2009;182(3):983-7.

Tritschler S, Roosen A, Füllhase C, Stief CG, Rübben H. Urethral Stricture: Etiology, Investigation and Treatments. Dtsch Arztebl Int. 2013;110(13):220-6.

Udo E. Is Post-Inflammatory Urethral Stricture Commoner Than Post-Traumatic Urethral Stricture? A Study in South-South Nigerian Hospital. Sch J App Med Sci. 2016;4(7F):2690-4.

Martins FE, Kulkarni SB, Joshi P, Jonathan Warner J, Natalia Martins N. Management of Long-Segment and Panurethral Stricture Disease. Advances in Urology. 2015.

Stein DM, Thum DJ, Barbagli G. A geographic analysis of male urethral stricture aetiology and location. BJU Int. 2013;112(6):830-4.

Ofoha CG, Shu’aibu SI, Akpayak IC, Dakum NK, Ramyil VM. Anastomotic Urethroplasty for Short Segment Bulbar Urethral Stricture; Experience at the Jos University Teaching Hospital, Jos. IOSR-JDMS. 2015;14(1):1-5.

Singh M, Blandy JP. The pathology of urethral stricture. J Urol. 1976;115(6):673-6.

Liedberg H. Catheter induced urethral inflammatory reaction and urinary tract infection. An experimental and clinical study. Scand J Urol Nephrol Suppl. 1989;124:1-43.

Latini JM, McAninch JW, Brandes SB, Chung JY, Rosenstein D. SIU/ICUD Consultation on Urethral Strictures: Epidemiology, Etiology, Anatomy, and Nomenclature of Urethral Stenoses, Strictures, and Pelvic Fracture Urethral Disruption Injuries. Urology. 2014;83(3):S1-7.

Kulkarni S, Joshi P, Surana S, Hamouda A. Management of panurethral strictures. Afr J Urol. 2016;22(1):33-9.

Alsagheer GA, Fathi A, Abdel-Kader MS, Hasan AM, Mohamed O. Management of long segment anterior urethral stricture (≥8cm) using buccal mucosal (BM) graft and penile skin (PS) flap: outcome and predictors of failure. Int Braz J Urol. 2018;44(1):163-72.

Warner JN, Malkawi I, Dhradkeh M, Joshi PM, Kulkarni SB. Amultiinstitutional evaluation of the management and outcomes of long-segment urethral strictures. Urology. 2015;85(6):1483-8.

Buckley J, McAninch JW. Distal penile circular fasciocutaneous flap for complex anterior urethral strictures. BJU International. 2007;100(1):221-31.

McAninch JW. Reconstruction of extensive urethral strictures: Circular fasciocutaneous penile flap. J Urology. 1993;149(3):488-91.

Atan A, Tuncel A, Balcı M, Aslan Y, Köseoğlu E, Erkan A. Penile fasciocutaneous flap urethroplasty in long segment urethral stricture. Ulus Travma Acil Cerrahi Derg. 2014;20(6):427-31.

Nadeem A, Zafar MR, Alvi MS, Kiani F, Asghar M. Use of Penile Skin Flap in Complex Anterior Urethral Stricture Repair: Our Experience. Pak Armed Forces Med J. 2017;67(1):89-92.

Kim KR, Suh J, Paick J, Kim SW. Surgical Outcome of Urethroplasty Using Penile Circular Fasciocutaneous Flap for Anterior Urethral Stricture. World J Mens Men Healt. 2014;32(2):87-92.