Outcome of 1-Stage Urethroplasty Using Oral Mucosal Grafts for the Treatment of Urethral Strictures Associated With Genital Lichen Sclerosus

Abstract

To report the outcome of 1-stage urethroplasty using lingual mucosal grafts (LMGs) and buccal mucosal grafts (BMGs) for the treatment of male urethral strictures associated with genital lichen sclerosus (LS). This was a descriptive, observational retrospective study of male patients with urethral strictures who underwent 1-stage mucosal graft urethroplasty using different substitute materials for reconstructive urethral surgery. Study inclusion criteria were patients with histologically proven LS presenting with urethral strictures. Exclusion criteria were patients without histologically proven LS, traumatic strictures, failed hypospadias, and malignant lesions. Successful reconstruction was defined as normal voiding with a peak flow >12mL/s, no obstructive symptoms, and no postoperative procedure, including dilation. Between January 2003 and December 2011, urethral strictures in 54 patients were considered associated with genital LS according to the inclusion and exclusion criteria, and 36 underwent 1-stage urethroplasty using oral mucosal grafts. The median age was 52years (range, 32-80years). The median stricture length was 12.5 ± 1.6cm (range, 6-18cm). One-stage single-sided dorsal LMG urethroplasty was performed in 22 of 36 patients. The remaining 14 patients received the same procedure combined with dual BMGs (n= 5) or with LMG combined with BMG (n= 9). The success rate was 88.9%. Postoperative urinary fistula occurred in 1 patient, and meatal stenosis developed in 3 patients. Mean follow-up was 38.7months (range, 12-110months). Our survey suggests that 1-stage urethroplasty with single or combined LMGs or BMGs may be aneffective option to treat urethral stricture associated with LS.