METHOD FOR THE TREATMENT OF EXTENDED ANTERIOR URETHRAL STRICTURES Russian patent published in 2021 - IPC A61B17/00 A61K35/15 A61K35/36 A61P13/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to urology. At the first stage of the operation, in which access to the altered part of the urethra is performed layer by layer, the dorsal wall of the urethra is dissected, including 1 cm of healthy tissue distal and proximal to the stricture. The dissected urethral wall is prepared in the center and the resulting urethral flaps are spread apart at a distance of at least 2 cm between their inner edges, so that the total width of the urethral site is at least 4 cm. The flaps are fixed to the tunica albuginea of ​​the corpora cavernosa with an interrupted suture. The skin of the penis is fixed to the urethral flaps "edge to edge". The area of ​​the resulting wound surface between the inner edges of the urethral flaps Su is determined. The area of ​​the required graft of the buccal mucosa Sb is calculated, the obtained value is rounded to tenths, while the Sb:Su ratio is 1:6. Buccal mucosa graft is collected. Graft prefabrication is performed. The obtained flap of buccal mucosa is washed in a solution of antibiotics with a volume of 2 ml, containing 0.1 mg/ml of gentamicin and 1 mg/ml of vancomycin. The flap is fragmented to micrografts about 1 mm in size. The first portion of fibrin-thrombin glue is applied to the wound surface between the urethral flaps at the rate of 1 ml per 10 cm² of surface Su. From above, micrografts of the buccal mucosa are evenly distributed over the entire area of ​​the defect. Above is the second portion of fibrin-thrombin glue from a similar calculation. The urethral catheter is removed 21-28 days after surgery. The second stage of the operation is carried out after 6 months. Tubularization of the neourethra around the installed catheter is performed with layer-by-layer suturing of the tissues of the penis.

EFFECT: method increases the efficiency and reduces the invasiveness of the operation due to the formation of the whole fragment of the neourethra without seams. The invention also helps to avoid postoperative secondary cicatricial changes and strictures.

1 cl, 7 dwg, 1 ex