COMPARATIVE ANALYSIS OF VENTRALAND DORSAL BUCCAL MUCOSA GRAFT AUGMENTATION URETHROPLASTY IN STRICTURE BULBAR URETHRA.

Abstract

Objective: To compare long term outcomes of buccal mucosa graft(BMG) augmentation urethroplasty for long-segment bulbar urethral strictures done by placing the graft ventrally and dorsally. Material and Methods: We conducted a single institution retrospective study on 32 patients who underwent BMG augmentation urethroplasty for non traumatic bulbar urethral stricture between January 2010- December 2018. The cases were divided into two groups based on the site of placement of the BMG graft i.e (a) Ventral (n=22) , (b)Dorsal(n=10). Follow-up period was from one year to five years. Patients with failed outcomes underwent Urethroscopy or Retrograde Urethrogram to note the site of recurrence of stricture. Results: Out of 32 cases 26 (81%) were successful and 6 (19%) failed.The success rates for ventral and dorsal BMG augmentation procedures were 81% and 70%,respectively(p=0.45).Among 6 failed cases 3 (9%)cases had stricture at proximal anastomotic site,2 (2%)cases at distal anastomotic site& 1 (1%)case at pan graft site(p=0.08). Conclusion: The overall success rate for BMG augmentation urethroplasty is equal for all techniques.Dorsal onlay urethroplasty provides better exposure of proximal anastomotic site thus it is associated with minimum proximal anastomotic site recurrence rates.Patient with extensive spongiofibrosis and long segment strictures had higher rate of failure.