Endoscopic skin-graft urethroplasty.

An attempt has been made to develop a treatment modality for urethral strictures that combines the minimally invasive nature and simplicity of optical urethrotomy with the good long-term results of tissue-graft urethroplasty. Purpose-specific instruments were designed for the carrying and holding of a full-thickness penile skin graft at the site of an urethral stricture, subjected to optical urethrotomy, in such a manner that movement between the graft and the graft bed be eliminated. The first 53 patients thus treated and followed for at least 2 years are discussed. The overall graft take was 95%. At the 2-year follow-up examination, patients with a good graft take showed maintained urethral patency in 100% of inflammatory and iatrogenic strictures, in 50% of established strictures resulting from rupture of the urethra associated with fracture of the pelvis, and in 75% of patients with rupture of the urethra treated 2-3 weeks after the injury.