Literature DB >> 27401984

Urethroplasty for treatment of long anterior urethral stricture: buccal mucosa graft versus penile skin graft-does the stricture length matter?

Mohamed M Hussein1, Hazem Almogazy2, Ahmed Mamdouh2, Fawzy Farag2, Elnesr Rashed2, Wael Gamal2, Ahmed Rashed2, Mohamed Zaki2, Esam Salem2, Ahmed Ryad2.   

Abstract

PURPOSE: To investigate the surgical outcomes of dorsal onlay urethroplasty (DOU) using buccal mucosa graft (BMG) or penile skin graft (PSG) and to assess the effect of stricture length in men with anterior urethral strictures.
METHODS: A prospective cohort included men with anterior urethral strictures between 2008 and 2015. Patients underwent DOU using PSG or BMG. Patients had urethrography and uroflowmetry at 0, 3, 6, 12 months, and urethroscopy when needed. Student's t test, Mann-Whitney U tests, and Pearson's Chi-square test were used for analysis.
RESULTS: Sixty-nine patients (43 ± 14 year) were included, 31 received BMG, and 38 received PSG. Mean stricture length was 8 ± 3 cm, mean operative time was 145 ± 31 min, and mean follow-up was 56 ± 10 mo. Success rate was 87 % (90 % BMG vs. 84 % PSG, p = 0.4). Mean operative time was significantly shorter in PSG group (136 ± 29 min vs. 256 ± 58 min, p = 0.0005). Complications of grade I developed in 36 % (wound infection = 10 %, postvoiding dribbling = 18.8 %). Thirty of 69 patients (43 %) had strictures ≥8 cm, and 39 (57 %) had strictures <8 cm-success rate was equal for both subgroups (87 %). Mean blood loss, mean operative time, and incidence of postvoid dribbling were significantly lower in strictures <8 cm.
CONCLUSION: BMG and PSG have comparable success rates in treatment of long anterior urethral strictures. Operative time is significantly longer in BMG. Long-segment strictures are associated with longer operative time, more blood loss, and more occurrence of postvoid dribbling. However, the length of the stricture has no influence on the success rate and functional outcomes of DOU.

Entities:  

Keywords:  Buccal mucosa graft; Dorsal onlay; Penile skin graft; Urethroplasty

Mesh:

Year:  2016        PMID: 27401984     DOI: 10.1007/s11255-016-1366-0

Source DB:  PubMed          Journal:  Int Urol Nephrol        ISSN: 0301-1623            Impact factor:   2.370


  14 in total

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4.  Management of complex anterior urethral strictures with multistage buccal mucosa graft reconstruction.

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5.  Outcome of 1-stage urethroplasty using oral mucosal grafts for the treatment of urethral strictures associated with genital lichen sclerosus.

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7.  A one-stage dorsal free-graft urethroplasty for bulbar urethral strictures.

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9.  Dorsal onlay urethroplasty using buccal mucosa graft versus penile skin flap for management of long anterior urethral strictures: a prospective randomized study.

Authors:  Mohamed G Soliman; Mohamed Abo Farha; Ahmed S El Abd; Hussein Abdel Hameed; Samir El Gamal
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10.  Histopathological characteristics of buccal mucosa transplants in humans after engraftment to the urethra: a prospective study.

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2.  Preoperative and intraoperative factors predictive of complications and stricture recurrence following multiple urethroplasty techniques.

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5.  'Pee'BuSt Trial: A single-centre prospective randomized study comparing functional and anatomic outcomes after augmentation  urethroplasty with penile skin graft versus buccal mucosa graft for anterior urethral stricture disease.

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Review 7.  Onlay Repair Technique for the Management of Ureteral Strictures: A Comprehensive Review.

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