Browsing by Author "Azorliade, Roland"

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    Dorsal Onlay Oral Mucosa Graft Urethroplasty: A Case Report and Review of Literature
    (Hindawi, 2020-10) Appiah, Kwaku Addai Arhin; Gyasi-Sarpong, Christian Kofi; Yenli, Edwin M. T.; Maison, Patrick Opoku Manu; Adofo, Charles Kwame; Amoah, George; Azorliade, Roland; Mintah, Dominic Annor; Badu-Peprah, Augustina; 0000-0003-0979-4006
    Urethral strictures in children are uncommon. They may present as lower urinary tract symptoms or acute urine reten tion [1]. The causes could be congenital, iatrogenic, posthy pospadias repair, or traumatic [2, 3]. The diagnosis involves a detailed history, physical examination, and appropriate radiological and endoscopic investigations [4]. Retrograde urethrography (RUG) with or without mictu rating cystourethrogram (MCUG) is the gold standard con firmatory test. In some situations, urethroscopy may berequired for confirmation and treatment. Penile and long bulbar urethral strictures are generally regarded as complexstrictures. This is because they do not lend themselves to simple excision and primary anastomosis [5]. They require tissue transfer in the form of grafts, flaps, or staged repair. Since the 1990s, the use of the buccal mucosal grafts to repair such complex anterior strictures has gained enormous popularity and acceptance due to its reproducibil ity and durable long term success rates of 85% and beyond [6–8]. Of significant debate is whether to place the graft ven trally or dorsally on the urethra. The dorsal approach seems cumbersome but the outcome is definitely better due to the mechanical support offered to the graft by the ventral aspect of the corporeal bodies [9–11]. We report on the successful application of the use of the oral mucosa graft dorsal onlay urethroplasty technique as described by Guido Barbagli [12] in a 14-year-old boy with a 7 cm Peno-bulbar urethral stricture at the Komfo Anokye
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    Urethroplasty among Elderly Men, Surgical Techniques and Outcomes
    (Scientific Research Publishing, 2024) Arhin Appiah, Kwaku Addai; Amoah, , George; Opoku Manu Maison, Patrick; Azorliade, Roland; Otu-Boateng, Kwaku; Arthur, Douglas; Annor Mintah, Dominic; Yorke, Joseph; 0000-0002-5229-0340
    Urethroplasty remains the gold standard for the management of urethral stricture. However, the treatment of stricture disease in the elderly tends to be less invasive due to the presumption that they might not be able to stand long hours of surgery and might have higher rates of recurrence due to poor wound healing from microangiopathy. We present our experience with the outcomes of urethroplasty among elderly men seen at the Komfo Anokye Teaching Hospital from January 2012 to December 2021. Methods: This was a retrospective review of data captured in the urology database on all patients 65 years and above who underwent urethroplasty at the hospital over the study period. Data was obtained on patients’ demographics, stricture characteristics, urethroplasty technique, and outcome. A successful outcome was defined as peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient satisfaction with urine stream, or restoration of the normal stream of urine with only one attempt at urethral calibration or internal urethrotomy post operatively. Data was analyzed using PASW Statistics for Windows, Version 18.0. Results: Overall, 43 urethroplasties were done over the study period in elderly men. The age range was 65 to 87 years. The commonest aetiology was catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bul bar urethral strictures. The repair methods employed were anastomotic ureth roplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethrop lasty (4.65%). Three of the patients (6.98%) had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Com plications included three surgical site infections, two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and the procedure should not be denied solely based on age.