Q-flap reconstruction of panurethral strictures

Objective: To review our experience with an extended Q-shaped penile skin flap for the reconstruction of panurethral strictures. Patients and methods: Between 1991 and 1999, 15 men with extensive strictures underwent a single-stage urethral reconstruction with a distal circumferential penile skin flap incorporating a ventral midline extension (Q-flap). None had undergone previous urethroplasty nor had any been circumcised. Results: The Q-flap provided a pedicled strip of penile skin with a mean (range) length of 17 (15-24)cm; no additional graft materials were necessary. Excellent results were obtained in 10 patients; in the remainder, complications included recurrent stricture (in two) and (in one patient each) a cerebral vascular accident, urethrocutaneous fistula, meatal stenosis, femoral neuropathy and prolonged catheterization for focal extravasation. Conclusion: The Q-flap provides an abundant hairless penile skin flap that enables single-stage panurethral reconstruction while eliminating the additional time and morbidity of harvesting further grafts.