ABSTRACT
The development of dorsal onlay graft urethroplasty represents a further refinement and evolution of the existing surgical techniques suggested for repair of urethral strictures. In 1979, Devine et al popularized the use of free skin grafts for urethroplasty.1 In 1980, Monseur described a new urethroplasty that involved opening the dorsal urethral surface and fixing the urethra over the corpora cavernosa, and leaving a catheter in place for a long period of time so as to obtain regeneration of the urethral mucosa.2 In 1996, we combined the techniques of Devine and Monseur, and described new penile and bulbar dorsal onlay graft urethroplasties.3 In our techniques the graft is sutured over the albuginea of the corpora and the urethra, fully opened along its dorsal surface, is sutured over the graft. The graft works as an epithelial buried roof-strip facilitating the regeneration of urethral mucosa and thus considerably reducing catheterization time. Moreover, the dorsal buried roof-strip facilitates mucosal regeneration without formation of scar tissue. Restoration of a wide urethra lumen may also be obtained by deep incision of the mucosal urethral plate at the midline and by dorsal inlay placement of the graft. Over time, our techniques have greatly improved and new changes are continuously being suggested.4
