MP13-05 VENTRALLY PLACED BUCCAL MUCOSAL GRAFT URETHROPLASTY FOR LONG ANTERIOR URETHRAL STRICTURE

Abstract

You have accessJournal of UrologyUrethra: Benign & Malignant Disease1 Apr 2014MP13-05 VENTRALLY PLACED BUCCAL MUCOSAL GRAFT URETHROPLASTY FOR LONG ANTERIOR URETHRAL STRICTURE Ehab Elkady, Ashraf Shahin, Mahmoud Eladl, and Usama Hassan Ehab ElkadyEhab Elkady More articles by this author , Ashraf ShahinAshraf Shahin More articles by this author , Mahmoud EladlMahmoud Eladl More articles by this author , and Usama HassanUsama Hassan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.674AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the results of buccal mucosal graft urethroplasty in repair of long anterior urethral stricture. METHODS Between July 2009 and Jan 2013, 33 patients with long anterior urethral stricture were operated as one stage ventral onlay buccal mucosal graft (BMG) urethroplasty. Patients with active UTI, history of VIU and/or urethroplasty within the last 3 months and those suffering from diseases of oral mucosa were excluded. Ascending urethrography and micturating cystourethrography were done for all patients. Uro-flowmetry was done as a base line for follow-up. The graft was tailored to stricture length and width then defatted and sutured to the edges of the opened urethra as ventral onlay. The donor site was followed-up for complications in the first week then after one and three months. The urethroplasty wound was followed-up for post-operative bleeding or infection. Whenever obstructive symptoms were met and flowmetry showed deterioration, urethrography was done. Successful reconstruction was equal to normal voiding without need for any postoperative procedure including dilatation. RESULTS Patients were divided into 3 groups (penile, bulbar and peno-bulbar) according to the actual intra-operative stricture site. Twenty two patients (66.67 %) had stricture length ≤ 5 cm, while 11 patients (33.33 %) had stricture length > 5 cm. The mean follow-up period was 20.5 (± 4.59) months .The overall success rate was 84.85% at the end of the study. The success rates were 85.71%, 81.82% and 86.67% for penile, bulbar and peno-bulbar urethroplasty groups respectively with statistically insignificant difference in relation to the site (P value = 0.9616). Re-stricture (failure) was reported in 5 patients, 4 of them had initial stricture length > 5 cm. The stricture length had a significant effect on the success rate, with strictures ≤ 5 cm having a better prognosis (P value = 0.0192). Extravasation at proximal anastomotic site was reported in 3 patients (9%) and was managed conservatively by catheter re-fixation for 2 weeks. Another two patients were complicated by urethroplasty wound infection and were managed conservatively with antibiotics. Early oral complications in the form of cheek swelling and perioral numbness occurred in all patients with spontaneous resolution within 48h. No late oral complications were noticed. CONCLUSIONS Ventrally placed buccal mucosa seems to be an excellent graft for repairing long anterior urethra stricture, regardless its site, with minimal donor and recipient site complications. Longer follow-up period is needed for evaluation of long term success. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e177 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Ehab Elkady More articles by this author Ashraf Shahin More articles by this author Mahmoud Eladl More articles by this author Usama Hassan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...