Different techniques in management of navicular fossa stricture, a single institution experience

Abstract

Background: Evaluation of the functional and cosmetic results after repair of different cases with fossa navicularis stricture by different techniques of urethroplasty. Methods: This study included 43 male patients with different lengths of fossa navicularis stricture of different age groups (8-60 years). History, clinical examination, ascending urethrogram (AUG), and voiding cystourethrogram (VUG) were reported for all patients. Primary outcome was functional assessment using AUG and VUG. Secondary outcomes were cosmetic evaluation using the HOSE score and 90-day complications. Follow-up duration was 2 years (at the 6th month, the end of the first year, and the end of the second year) by clinical examination, flow rate, urethrogram, and urethrocystoscopy. Results: Cosmetic and functional success was achieved in 39 patients (90.6%). Follow-up was for 24 months. The flow rate had improved up to 15.3ml/sec. Four patients developed complications, one patient with restricture, two patients with subcoronal fistula, and one with glanular disruption. Conclusion: Different techniques were used for the repair of fossa navicularis stricture. The choice of suitable technique was according to different findings such as length of stricture, urethral caliber, associated Lichen sclerosus (LS), availability of penile skin, and hair distribution. The technique of repairing fossa navicularis stricture with the use of the transverse penile island flap with the glans cap keeps the glanular shape and configuration intact with optimum function.