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Page 10 of 12 Dávila et al. Plast Aesthet Res 2022;9:31 https://dx.doi.org/10.20517/2347-9264.2021.133

CONCLUSION
The combined use of a graft, usually oral mucosa, and a genital skin flap is a safe, predictable, and long-
lasting approach to single-stage reconstruction of lengthy and complex urethral stricture disease. With a
proper patient selection, this combined modality proved to be a more efficient method to handle these
complex stricture scenarios. This combination consists of a dorsal OMG to augment or replace the
insufficient urethral plate, followed by a ventral onlay penile skin flap procedure.

Therefore, grafts and flaps have been paramount in the surgical reconstruction of urethral strictures and
should continue as an essential instrument in the resources of the reconstructive surgeon. However,
comparing the success rates of this combined technique with other reconstructive procedures is challenging
at the present time. Nonetheless, the graft and flap combination appears to be very rewarding for well-
selected patients as long as a variety of factors are considered.

Further randomized studies will be mandatory to support one technique over another. Until then, it is vital
for the reconstructive surgeon to feel confident with a wide array of techniques to address the best treatment
approach for each individual patient.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: Dávila F, Rosito T
Provided administrative, technical, and material support: Stojanovic B
Drafted the work and substantively revised it, made substantial contribution to conception and design of the
study: Martins FE

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declare that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2022.

REFERENCES
1. Fossati N, Barbagli G, Larcher A, et al. The surgical learning curve for one-stage anterior urethroplasty: a prospective single-surgeon
study. Eur Urol 2016;69:686-90. DOI PubMed
2. Giudice CR, Becher E, Olivares AM, Tobía I, Favre GA. Dorsal oral mucosa graft in combination with ventral penile flap as an
alternative to repair obliterative stenosis of the anterior urethra in a single surgical time. Int Braz J Urol 2020;46:83-9. DOI