TRAUMA, AND GENITAL AND URETHRAL RECONSTRUCTION
Branching patterns of the dorsal nerve of the penis (DNP) were carefully documented during delicate cadaveric dissections performed under a stereoscopic dissection microscope. The take home message is that branches were identified emerging from the inferior (deep) surface of the body of the DNP coursing directly into the tunica in roughly three fourths of the specimens. Lateral traction of the DNP during mobilization could be expected to cause traction injury to the delicate subtending nerve branches. Longitudinal incisions through the Buck fascia parallel to the DNP are recommended to enable plication suture placement without lateral neural traction. The authors conclude that some degree of neural injury seems unavoidable during incision or partial excision of a dorsal Peyronie disease plaque. Allen F. Morey, MD
Re: Prospective Evaluation of a New Visual Prostate Symptom Score, the International Prostate Symptom Score, and Uroflowmetry in Men with Urethral Stricture Disease S. G. Wessels and C. F. Heyns Department of Urology, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa Urology 2014; 83: 220e224.
Abstract available at http://jurology.com/ Editorial Comment: This study evaluates the usefulness of a visual pictogram scale for male patients with stricture. The authors report that the visual score correlated well with International Prostate Symptom Score, peak urinary flow rate and urethral diameter, and that it takes significantly less time to complete. This information may be useful to facilitate the evaluation of patients with stricture in whom language and/or educational barriers may be significant. Allen F. Morey, MD
Re: Outcome of 1-Stage Urethroplasty Using Oral Mucosal Grafts for the Treatment of Urethral Strictures Associated with Genital Lichen Sclerosus Y. M. Xu, C. Feng, Y. L. Sa, Q. Fu, J. Zhang and H. Xie Department of Urology, Affiliated Sixth People’s Hospital, Shanghai Jiaotong University, and Shanghai Eastern Institute for Urologic Repair and Reconstruction, Shanghai, China Urology 2014; 83: 232e236.
Abstract available at http://jurology.com/ Editorial Comment: The authors present their extensive experience with 1-stage onlay urethroplasty in 54 patients from China with lichen sclerosus. Lingual and buccal mucosa grafts were incorporated into a dorsal longitudinal urethral incision following 1-sided dissection, as popularized by Kulkarni et al.1 The results indicate this is a viable technique, with nearly 90% effectiveness. The most common complication noted was meatal stenosis. It is for this reason that we have recommended performing extended meatotomy in conjunction with long onlay repairs in similar cases.2 Allen F. Morey, MD 1. Kulkarni S, Barbagli G, Kirpekar D et al: Lichen sclerosus of the male genitalia and urethra: surgical options and results in a multicenter international experience with 215 patients. Eur Urol 2009; 55: 945. 2. Morey AF, Lin HC, DeRosa CA et al: Fossa navicularis reconstruction: impact of stricture length on outcomes and assessment of extended meatotomy (first stage Johanson) maneuver. J Urol 2007; 177: 184.