Laparoscopic omentoplasty to support anastomotic urethroplasty in complex and redo XXXX .

@entity1 @entity174 @entity254 @entity3832 @entity130
OBJECTIVE: To test the hypothesis that a new surgical technique using elaborated perineal anastomotic urethroplasty combined with laparoscopic omentoplasty for @entity1 with complex and prior failed @entity174 repair was feasible, safe, and effective. METHODS: We performed a prospective, observational, stage 2a study to observe treatment outcomes of combined perineal and laparoscopic approach for urethroplasty in @entity1 with @entity174 at a single center in Pune, India, between January 2012 and February 2013. Complex and redo @entity1 with @entity174 occurring after @entity174 @entity130 were included in the study. @entity3832 were excluded. The primary study outcome was the success rate of the surgical technique, and the secondary outcome was to evaluate feasibility and safety of the procedure. The clinical outcome was considered a failure when any postoperative instrumentation was needed. RESULTS: Fifteen male @entity1 with a median age of 19 years were included in the study. Seven @entity1 were adolescents (12-18 years) and 8 @entity1 (53.3%) were adults (19-49 years). The mean number of prior urethroplasties was 1.8 (range, 1-3). All @entity1 underwent @entity254 using a perineal approach with inferior pubectomy combined with laparoscopic mobilization of the omentum into the perineum to envelope the @entity254 and to fill the perineal dead space. Of 15 @entity1 , 14 (93.3%) were successful and 1 (6.6%) failed. One adolescent @entity1 14 years old developed a recurrent stricture 2 months after the procedure and was managed using internal urethrotomy. Median follow-up was 18 months (range, 13-24 months). CONCLUSION: Combining a laparoscopic omentoplasty to a membranobulbar @entity254 for complex and redo @entity174 @entity130 is successful, feasible, safe, and with minimal additional morbidity to the @entity1 . The technique has the advantage of a perineal incision and the ability to use the omentum to support the @entity254 .
