840 SINGLE-STAGE DORSAL ONLAY BUCCAL MUCOSA GRAFT URETHROPLASTY FOR COMPLEX (PENDULOUS AND PAN-UREHTRAL) STRICTURES

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You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011840 SINGLE-STAGE DORSAL ONLAY BUCCAL MUCOSA GRAFT URETHROPLASTY FOR COMPLEX (PENDULOUS AND PAN-UREHTRAL) STRICTURES Anand Sehgal and Harpreet Jolly Anand SehgalAnand Sehgal Ludhiana, India More articles by this author and Harpreet JollyHarpreet Jolly Ludhiana, India More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.660AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Buccal mucosa graft (BMG) is considered the tissue of choice for single stage reconstruction of the bulbar urethral strictures but its use for pendulous and pan-anterior urethral strictures has not been reported widely. This study was done to assess the outcome of single-stage dorsal onlay BMG urethroplasty for pendulous and pan-urethral strictures in terms of voiding function, erectile function and morbidity of oral cavity. METHODS A total of 44 patients underwent dorsal onlay buccal mucosa graft urehtroplasty from October 2006 to March 2010 out of which 21 were complex strictures involving pendulous urethra only (6), segments of both pendulous and bulbar urethra (6) and pan-urethral strictures (9). Age of the patients ranged from 30 to 67 (mean=51.8) years. Mean graft length was 9.5 cm (range, 6-16 cm). Etiology of the stricture was instrumentation (9), balanitis xerotica obliterans (5) and idiopathic (7). Ten patients underwent OIU and 4 patients had got suprapubic cystostomy done prior to surgery. Buccal mucosa graft site was left unsutured in all cases after securing hemostasis. All procedures were done through perineal incision. Recurrence rates, need for further procedures, erectile dysfunction and complications were analysed retrospectively. RESULTS Eighteen (85.7%) patients were stricture free at a mean follow up of 33.4 (range, 8–48) months. All 3 (14.3) recurrences presented within first 7 months of the procedure, 2 were panurethral strictures out of which one required meatal dilatation and other required OIU. One pendulous urethral stricture also required OIU. Two patients (both panurethral) complained of significant chordee. No patient complained of deterioration of erectile function after the procedure however 1 noted improvement in sexual activity. Four (19%) patients continued to have graft site numbness even after 6 months. No patient complained of difficulty in mouth opening. CONCLUSIONS Pendulous and panurethral strictures can be reconstructed satisfactorily by single stage dorsal onlay buccal BMG urethroplasty with acceptable complication rates. Leaving graft site unsutured causes minimal post-operative morbidity. Possibility of chordee (in patients with pan-urethral strictures) and numbness of oral mucosa should be explained to the patients before the procedure. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e337-e338 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anand Sehgal Ludhiana, India More articles by this author Harpreet Jolly Ludhiana, India More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...