Abstract
ABSTRACTPurposeTo evaluate the surgical outcome and predictors of failure of substitution urethroplasty using either dorsal onlay buccal mucosal (BM) graft or ventral onlay penile skin flap (PS) for anterior urethral stricture ≥ 8cm.Patients and methodsBetween March 2010 and January 2016, 50 patients with anterior urethral stricture ≥ 8 cm were treated at our hospital. The surgical outcome and success rate were assessed. The predictors of failure were analyzed using multivariate analysis. Failure was considered when subsequent urethrotomy or urethroplasty were needed.ResultsDorsal onlay BM graft was carried out in 24 patients, while PS urethroplasty in 26 patients. There was no significant difference between both groups regarding patients demographics, stricture characteristics or follow-up period. One case in the BM group was lost during follow-up. Stricture recurrence was detected in 7 (30.4%) patients out of BM group while in 6 (23.1%) patients out of PS group (p value= 0.5). No significant differences between both groups regarding overall early and late complications were observed. Occurrence of early complications and the stricture length were the only predictors of failure in univariate analysis, while in multivariate analysis the occurrence of early complications was only significant.ConclusionOn short-term follow-up, both dorsal onlay BM graft and ventral onlay PS flap urethroplasty have similar success rates. However, BM graft has a potential advantage to reduce operative time and is also technically easier. The surgeon should avoid early local complications as they represent a higher risk for failure.
Highlights
The gold standard treatment option for anterior urethral stricture not amenable by anastomotic urethroplasty is tissue transfer using either flap or graft
Substitution urethroplasty is usually done as a one stage procedure using flap or graft as an onlay patch after stricturotomy, while a 2-stage procedure may be required in cases with severely narrowed lumen or with inadequate blood supply or tissue coverage [5]
Many studies have discussed the substitution urethroplasty for short segment anterior urethral stricture, only limited studies investigated the management of long segment stricture which is a challenging problem [6]
Summary
The gold standard treatment option for anterior urethral stricture not amenable by anastomotic urethroplasty is tissue transfer using either flap or graft (buccal, intestinal mucosa and tissue engineered). Ibju | Treatment of long segment anterior urethral stricture using buccal mucosal graft and penile skin flap. Few studies compared penile skin flap versus buccal mucosa graft as an onlay substitution for reconstruction of long segment anterior urethral stricture and the predictors of failure are still not defined in the literature. This is a retrospective study of 56 patients who underwent onlay substitution urethroplasty for long segment anterior urethral stricture ≥ 8 cm between March 2010 and January 2016. Ibju | Treatment of long segment anterior urethral stricture using buccal mucosal graft and penile skin flap Figure 3 - Ventral onlay circular penile flap augmentation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International braz j urol : official journal of the Brazilian Society of Urology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
