Miodrag Acimovic1, Bogomir Milojevic2, Marko Milosavljevic3, Marta Skrodzka4, Milan Radovanovic2, Dragutin Rafailovic2, Zoran Dzamic2, Jovan Hadzi Djokic5, Rados Djinovic6. 1. Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia. drmiodragacimovic@gmail.com. 2. Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia. 3. General Hospital Bel Medic, Belgrade, Serbia. 4. Department of Urology, University Hospital of Bialystok, Białystok, Poland. 5. Serbian Academy of Sciences and Arts, Belgrade, Serbia. 6. Sava Perovic Foundation (RD), Belgrade, Serbia.
Abstract
PURPOSE: To report our ongoing experience with dorsal buccal mucosa graft (BMG) urethroplasty for the primary repair of anterior urethral strictures in patients with lichen sclerosus (LS). PATIENTS AND METHODS: A total of 32 men with LS underwent BMG urethroplasty from January 2010 to September 2012. In 27 patients, stricture was limited to the penile urethra, while in five patients, both bulbar and penile urethra were involved. In these five patients, the entire anterior urethra was replaced with BMG. In nine (28.1%) younger patients (mean age 38.2 years, range 33-45), with adverse local conditions and significant scarring, two-stage repair was done. The paired t test was performed on preoperative and postoperative Qmax as well as on preoperative and postoperative post-void residual urine volume, and the Fisher exact test was used to assess success between treatment groups. The chi-squared test was used to compare categorical data. RESULTS: The overall success rate was 90.6%. Complications occurred in 9.4% of the patients (3 of 32) including hematoma in two patients and fistula in one patient. In this cohort of patients, mean preoperative Qmax was 6.2 ml per second (range 2.6-10.2) versus 18.2 (range 15.8-21.2) postoperatively (at 9 months), which was statistically significant (p < 0.002). Also, mean preoperative post-void residual urine volume was 110 ml (range 75-180) versus 19 ml (range 10-40) postoperatively at 9 months, which was statistically significant (p < 0.004). CONCLUSION: Buccal mucosa is the most reliable graft for repairing anterior urethral strictures in patients with LS. Minimal complications are observed, even in cases of long stenosis completely afflicting anterior urethra.
PURPOSE: To report our ongoing experience with dorsal buccal mucosa graft (BMG) urethroplasty for the primary repair of anterior urethral strictures in patients with lichen sclerosus (LS). PATIENTS AND METHODS: A total of 32 men with LS underwent BMG urethroplasty from January 2010 to September 2012. In 27 patients, stricture was limited to the penile urethra, while in five patients, both bulbar and penile urethra were involved. In these five patients, the entire anterior urethra was replaced with BMG. In nine (28.1%) younger patients (mean age 38.2 years, range 33-45), with adverse local conditions and significant scarring, two-stage repair was done. The paired t test was performed on preoperative and postoperative Qmax as well as on preoperative and postoperative post-void residual urine volume, and the Fisher exact test was used to assess success between treatment groups. The chi-squared test was used to compare categorical data. RESULTS: The overall success rate was 90.6%. Complications occurred in 9.4% of the patients (3 of 32) including hematoma in two patients and fistula in one patient. In this cohort of patients, mean preoperative Qmax was 6.2 ml per second (range 2.6-10.2) versus 18.2 (range 15.8-21.2) postoperatively (at 9 months), which was statistically significant (p < 0.002). Also, mean preoperative post-void residual urine volume was 110 ml (range 75-180) versus 19 ml (range 10-40) postoperatively at 9 months, which was statistically significant (p < 0.004). CONCLUSION: Buccal mucosa is the most reliable graft for repairing anterior urethral strictures in patients with LS. Minimal complications are observed, even in cases of long stenosis completely afflicting anterior urethra.
Authors: Christopher J Kane; Gregory J Tarman; Duncan J Summerton; Craig E Buchmann; John F Ward; Keith J O'Reilly; Henry Ruiz; J Brantley Thrasher; Burk Zorn; Carolyn Smith; Allen F Morey Journal: J Urol Date: 2002-03 Impact factor: 7.450
Authors: Ahmed M Reyad; Ahmed Mamdouh; Elnisr Rashed; Atef Fathi; Osama Mahmoud; Ahmed Hasan Journal: Int Urol Nephrol Date: 2018-06-09 Impact factor: 2.370