Objective. To present the results of reconstruction of long (>5 cm), penile, bulbar, and bulbopenile urethral strictures by penile skin flap as dorsal onlay in one-stage procedure. Patients and Methods. Between January, 1998 and December, 2004, 18 patients (aged from 28-65 years) presented with long urethral strictures, 5.6–13.2 cm (penile in 6, bulbar in 2 and combined in 10 cases), those were repaired utilizing long penile skin flaps placed as dorsal onlay flap in one stage (Orandi flap 6 cm in 6 cases, circular flaps 7–10 cm in 8, and spiral flaps 10–15 cm in 4). Followup of all patients after reconstruction included urine flow rate at weekly intervals, RUG at 6–12 weeks, and urethrocystoscopy at 12 and 18 months. Results. The urethral patency was achieved in 77% of patients. The complications were fistula in one patient (5.5%), restricture occurred in 3 patients (16.6%) that required visual internal urethrotomy and two patients (11%) showed curvature on erection that dose not interfere with sexual intercourse. Diverticulum (penile urethra) was seen in one patient (5.5%) containing stones and was excised surgically. There was penile skin loss in 3 patients (16.6%). All patients completed at least one-year followup period. Conclusion. Free penile skin flaps offer good results (functional and cosmetic) in long penile and/or bulbar urethral strictures. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.
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机译：目的。以一阶段程序通过阴茎皮瓣作为背侧覆盖物重建长（> 5 cm），阴茎，延髓和延髓性尿道狭窄的结果。患者和方法。在1998年1月至2004年12月之间，有18例（年龄在28-65岁之间）出现尿道狭窄，长5.6–13.2 cm（阴茎6例，延髓2例，合并10例），这些患者经长阴茎修复皮肤皮瓣作为背侧皮瓣放置在一个阶段（Orandi皮瓣6 cm 6例，圆形皮瓣7-10 cm 8例，螺旋皮瓣10-15 cm 4例）。重建后所有患者的随访包括每周间隔尿流率，6-12周RUG和12个月和18个月尿道膀胱镜检查。结果。 77％的患者实现了尿道通畅。并发症为瘘管，一例（5.5％），狭窄发生在三例（16.6％），需要进行视觉内尿道切开术，两名患者（11％）出现勃起弯曲，且不影响性交。一名患有结石的患者（5.5％）发现憩室（阴茎尿道），并通过手术切除。 3名患者（16.6％）出现阴茎皮肤损失。所有患者至少完成了一年的随访期。结论。游离的阴茎皮瓣在长的阴茎和/或延髓性尿道狭窄中具有良好的效果（功能性和美容性）。精心制作的纵向，圆形或螺旋形的阴茎皮肤皮瓣可桥接长达15 cm的尿道缺损。
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