Abstract

Objectives: Lots of urethroplasty techniques, mostly difficult surgical managements, were described in the literature to date but there has been not a golden standard because of their considerable risk of morbidity. Although various synthetic materials were tried to reconstruct the urinary tract, especially the ureter, similar techniques with synthetic materials have not been studied in every aspect in urethra to date. In the present study, we aimed to use ringed polytetrafluoroethylene (PTFE) tube graft for the replacement of proximal urethra and to evaluate its suitability in urethral replacement in a canine model.

Material and Method: Two male dogs underwent distal urethral replacement with 6-mm ringed PTFE tubing graft under general anesthesia. For this purpose, a 1 cm distal urethra was mobilized and excised. The proximal and distal ends of remainder urethra were spatulated. The graft was interposed with interrupted 4-0 polyprophylene stitches. Two weeks after the operation, graft was harvested with concomitant urethra. Proximal end of the urethra was examined macroscopically and microscopically for evidence of patency and epithelial ingrowth into the graft. The remaining urethra was fistulised to the ventral penis thereafter.

Results: At the second week, a small fistula formation and urine leakage were observed at the distal side of the anosthomosis in one dog. At the macroscopic histological examination, scar tissue was also observed through the graft in both of the proximal and distal site of urethra. Although PTFE graft was not obstructed, there was severe fibrosis at the proximal and distal anostomotic site and no evidence of epithelial lining in the graft lumen but the trace of epithelium under the greft were depicted at the histological examination.

Conclusion: Replacement with ringed PTFE tube graft is not a successful procedure in the surgical treatment of urethral defect as in the ureteral replacements. However, further studies are needed on this topic