MP56-16 ONE-STAGE URETHROPLASTY USING DORSAL-VENTRAL BUCCAL MUCOSAL GRAFT: LONG-TERM, VALIDATED PATIENT REPORTED OUTCOMES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-16 ONE-STAGE URETHROPLASTY USING DORSAL-VENTRAL BUCCAL MUCOSAL GRAFT: LONG-TERM, VALIDATED PATIENT REPORTED OUTCOMES John Barnard, and Joel Gelman John BarnardJohn Barnard More articles by this author , and Joel GelmanJoel Gelman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The dorsal-ventral or "double face" buccal mucosa graft urethroplasty (BMG-U) via a dorsal approach was first described in a series of 18 patients in 2014. When the corpus spongiosum is intact, this surgery is appropriate for a 1-stage reconstruction where there is obliteration or near obliteration of a segment too long for anastomotic or augmented anastomotic urethroplasty (AAU). This technique is also a non-transecting alternative to AAU for shorter strictures unsuitable for onlay repair alone. Our objective was to provide global, validated and urethroplasty specific patient reported outcomes (PROMs) with this technique with up to 21 year follow up. METHODS: Patients were prospectively enrolled in our IRB approved urethroplasty outcomes study from 1998 to present. Anatomic success was assessed by cystoscopy >4 months after surgery. Long-term outcomes were assessed using the International Prostate Symptom Score (IPSS) and a 6Q-LUTS urethroplasty specific PROM, the Sexual Health Inventory for Men (SHIM), and the Male Sexual Health Questionnaire Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). A Student’s t-test evaluated differences in means for the PROMs with significance at p < 0.05. RESULTS: 38 patients underwent BMG-U. Mean age at surgery was 50.5 years (19.2-77.5). Mean follow-up was 78 months (13.4-262.4). The anatomic success rate was 97.2%, and the long-term functional success was 97.4%. Significant improvement was observed in IPSS (including quality of life metric) and 6Q-LUTS post-operatively, and this difference was sustained. No difference in SHIM or MSHQ-EjD-SF was observed. Overall satisfaction was 97.4%, and 91.9% stated they would undergo surgery again knowing their outcome. CONCLUSIONS: The dorsal-ventral BMG-U via a dorsal approach is associated with high patient satisfaction, and validated PROMs demonstrate lasting effect with no significant detriment to erectile and ejaculatory function. It was recently reported that for bulbar strictures, AAU was an independent risk factor for recurrence. Although we did not perform a comparative study, we speculate that the absence of urethral transection may be a factor contributing to a successful outcome that is comparable to the published results for strictures amenable to dorsal onlay substitution urethroplasty. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e975-e975 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Barnard More articles by this author Joel Gelman More articles by this author Expand All Advertisement Loading ...