Duplo enxerto Inlay + Onlay para estenose uretral

A urethral reconstruction technique using two grafts in complementary positions.

A urethral stricture occurs when the urethral channel narrows, which may impair urinary flow and, in more complex cases, require surgical reconstruction.

In the duplo enxerto Inlay + Onlay technique, two grafts are used in different planes of urethral reconstruction. This combination allows the reconstructed surface to be expanded and the technique to be adapted to the affected segment.

The choice of approach depends on the extent, location and complexity of the stricture, as well as the quality of available tissues.

Planning starts with assessment of the affected urethral segment and surrounding tissue conditions.

Combining inlay and onlay grafts allows different urethral surfaces to be addressed during reconstruction, distributing the grafts in a complementary way.

• Inlay

  The graft is placed in an internal plane of urethral reconstruction, according to the technique chosen for that segment.

• Onlay

  The graft is applied as an addition over another urethral surface, expanding the reconstruction area.

• Combined reconstruction

  Using both grafts together allows reconstruction to be adapted to situations in which a single approach may be insufficient for the affected segment.

The indication is individual and depends on assessment of the urethral stricture.

The surgeon considers factors such as:

• Location of the stricture
• Extent of the affected segment
• Degree of scarring and fibrosis
• Quality of urethral tissues
• Previous surgery or procedures
• Availability of graft tissue

The technique tends to be considered in more complex reconstructive situations in which urethral reconstruction needs to be expanded or supplemented.

Treatment of a urethral stricture does not depend only on the length of the narrowing.

The surgical decision also considers the quality of the recipient bed, local blood supply, previous scars and the history of earlier interventions.

Duplo enxerto Inlay + Onlay should therefore not be understood as a technique applied uniformly to every patient.

Planning is defined according to anatomy and the complexity of the required reconstruction.

As with other urethral reconstruction procedures, there may be risks involving healing, infection, recurrent stricture, fistula formation, changes in urinary flow and the need for further interventions.

Progress depends on factors such as stricture extent, tissue quality, previous surgery and case complexity.

No technique completely eliminates the risk of recurrence, and postoperative follow-up is part of treatment.