MP56-19 PROMISING PRELIMINARY RESULTS FOR VENTRAL ONLAY BUCCAL MUCOSAL GRAFT URETHROPLASTY IN FOSSA NAVICULARIS STRICTURES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-19 PROMISING PRELIMINARY RESULTS FOR VENTRAL ONLAY BUCCAL MUCOSAL GRAFT URETHROPLASTY IN FOSSA NAVICULARIS STRICTURES Alejandra Perez, Adam Nolte, Chase Mallory, Scott Jamieson, Jessica Boyer, Dhaval Jivanji, Spencer Liem, George Wayne, and Billy Cordon Alejandra PerezAlejandra Perez More articles by this author , Adam NolteAdam Nolte More articles by this author , Chase MalloryChase Mallory More articles by this author , Scott JamiesonScott Jamieson More articles by this author , Jessica BoyerJessica Boyer More articles by this author , Dhaval JivanjiDhaval Jivanji More articles by this author , Spencer LiemSpencer Liem More articles by this author , George WayneGeorge Wayne More articles by this author , and Billy CordonBilly Cordon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nearly twenty percent of all anterior urethral strictures occur at the fossa navicularis (FN). Management balances restoring urethral patency while maintaining adequate cosmesis. Historically, FN strictures are often managed via glans cap or glans wings, and in severe cases, multi-stage procedures. Augmentation with ventral onlay buccal mucosal grafts (VOBMG) has been traditionally discouraged for fear of poor graft support and risk of fistula formation. METHODS: We retrospectively reviewed clinical and procedural characteristics for all patients with FN strictures that underwent urethroplasty at our institution from August 2016 through February 2021. Our approach included a ventral incision from the meatus to corona leaving a dorsal strip of native urethra to which BMG graft is anastomosed over a 20-24F catheter. A glansplasty is then performed to support the graft. Outcomes included recurrence rates and complication rates. RESULTS: We identified 14 patients that underwent urethroplasty for isolated fossa navicularis strictures. Of these, 9 underwent a single stage VOBMG urethroplasty. Other approaches included staged Johansson repair, mucosal advancement, and fasciocutaneous flaps with glans cap, which were excluded from analysis. Average follow up period to date was 25.8 months. 1/9 (11%) developed a stricture recurrence requiring intervention with balloon dilation, after which there has been no further recurrence at 20 months follow-up. No UTIs, fistulae, or other complications were seen. CONCLUSIONS: Our research demonstrates that single-stage VOBMG is an effective means of treating FN strictures. Despite a limited number of cases, our series demonstrates promising short-term safety and efficacy for this procedure, carrying significant advantages over dilation and staged reconstruction. We observed good graft take, successful cosmetic and functional outcomes and no evidence of urethra-cutaneous fistulas. Further series follow-up and comparative data will help to elucidate durability of outcome and refine treatment options. Source of Funding: n/a © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e976-e976 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alejandra Perez More articles by this author Adam Nolte More articles by this author Chase Mallory More articles by this author Scott Jamieson More articles by this author Jessica Boyer More articles by this author Dhaval Jivanji More articles by this author Spencer Liem More articles by this author George Wayne More articles by this author Billy Cordon More articles by this author Expand All Advertisement Loading ...