Buccal mucosal dorsal substitution urethroplasty in recurrent anterior urethral stricture

Abstract

Objective: To evaluate the durability of dorsal free graft aurethroplasty using buccal mucosa in adult recurrent bul-bar and pendulous urethral strictures. Patients and Methods: We treated 40 patients with re-current bulbar and penile urethral strictures during a pe-riod of 4 years. Mean age was 40 years. All patients underwent single stage urethral reconstruction using non-tubularized dorsal onlay buccal mucosa graft. The length of stricture dealt with was in the range of 2.5 cm to 12 cm. Follow-up was done at 3 weeks, 3 months, 6 months and then yearhv by uroflowmetry and if required by retrograde urethrogram. Results: Outcome was favourable in 38 patients (95%). 1 patient (2.5%) required VIU. I patient (2.5%) died due to pulmonary embolism in immediate postoperative pe-riod. Conclusions: Buccal mucosa is easy to harvest. It has thin and well- vascularized lamina propria with efficient imbibitions. Free graft placed dorsally over the tunica gains the mechanical support of the corpora and obviates urethrocele or diverticula formation. The technique offers the advantages of a fixed well-vascu larized surface with improved graft neo-vasculari-ation, reduced graft shrink-age, and optimum durability of graft.

Keywords

• Urethra
• urethral stricture
• craft survival
• mucous membrane.