Long-term follow-up for reconstruction of strictures of the fossa navicularis with a single technique

OBJECTIVE: To retrospectively review our experience with the ventral transverse skin island elevated on a dartos fascia flap. PATIENTS AND METHODS: In all, 45 patients were consecutively operated by the senior author using this technique from March 1987 to January 2006. The files of 35 patients were assessed for the study. Success was defined as a patent urethral calibre of >/=16 F that did not require further procedures. Follow-up consisted of, endoscopy with calibration, office visits, and telephone calls. This procedure was described in 1987 by Jordan. The overall outcome as well as indications after the follow-up period are presented. RESULTS: The overall success rate was 83% with a mean long-term follow-up of 10.2 years. All of the patients with a non-lichen sclerosus (LS)/balanitis xerotica obliterans (BXO) diagnosis had excellent results (23/23) with a mean follow-up of 10.2 years. LS/BXO recurred at the fossa or meatus in six of 12 patients. Seventeen patients (48%) were lost to follow-up, and three patients (9%) died from other causes. CONCLUSIONS: The ventral transverse penile skin island flap has proven to be effective, reliable, reproducible, and with good functional and aesthetic results in all fossa navicularis strictures with the exception of those strictures resulting from LS/BXO.