Augmented urethroplasty with pseudospongioplasty in the treatment of penile strictures

Strictures involving the penile urethra generally require tissue transfer techniques. Ventral graft placement usually is avoided in the penile urethra because of the relative paucity of viable corpus spongiosal tissue necessary for vascularization and support. Instead, grafts are commonly placed dorsally using either an onlay or inlay technique. However, the successful use of ventrally placed grafts in the penile urethra supported by a pseudospongioplasty has recently been reported. The incorporation of a pseudospongioplasty provides a well-vascularized milieu for successful graft take in the penile urethra. This technique incorporates periurethral flaps of tunica dartos and Buck’s fascia for graft coverage. Pseudospongioplasty in the penile urethra has been shown to have a similar efficacy to standard spongioplasty in the bulbar urethra. Additionally, pseudospongioplasty outcomes are comparable to other graft augmentation techniques performed in the penile urethra. In penile strictures, where there is a paucity of spongiosal tissue, pseudospongioplasty for coverage of a ventral graft is a reliable option.