Abstract
Purpose. Although the use of buccal mucosa in substitution urethroplasty has been practiced for some years, it has not been free of controversy over which surgical technique is the most appropriate to use. There is paucity of data in Sub-Saharan Africa about its success; this study presents the outcomes of dorsal and ventral buccal graft urethroplasty at a sub-Saharan tertiary hospital. Methods. This is a prospective study in which buccal mucosa was used for ventral and dorsal grafts; followup was up to two years. All patients provided informed written consent for the procedures. Results. Seventy-two patients with bulbar urethral strictures underwent buccal graft one-stage urethroplasty. Mean age was 55 years; etiology of the strictures was postinflammatory due to urethritis from sexually transmitted infections 97% (70/72) and trauma 3% (2/72). Buccal mucosa grafts were harvested from the cheek using a two-team approach. Grafts were placed on the ventral and dorsal urethral surfaces in 32 and 40 cases, respectively; the success rate was 84 and 80%, respectively. Repeated urethroplasty was successfully done among 10% (7/72) and patients reported resolution of symptoms in the follow-up period. Conclusion. There was no difference between dorsal and ventral onlay buccal graft outcomes for bulbar urethral strictures. The success rate was 80 to 84%.
Highlights
Urethral stricture is a chronic and common urological problem and difficult to manage fraught with high patient morbidity and stricture recurrence [1, 2].Since the resurgence in the use of buccal mucosa grafts (BMG) in substitution urethroplasty in the late 1980s, there has been controversy over which surgical technique is the most appropriate for its application
BMG has become an ideal urethral substitute because of ease of harvest, surgical handling characteristics, hairlessness, and compatibility in a wet environment and it is early in growth and graft survival; because of these unique characteristics, buccal mucosa has gained popularity in the realm of reconstructive urology
Consecutive patients presenting with difficulty in passing urine due to a penile urethra stricture were recruited in two phases: over a 12-month period for dorsal onlay grafting and the subsequent 12 months another set was recruited for ventral onlay grafting
Summary
Urethral stricture is a chronic and common urological problem and difficult to manage fraught with high patient morbidity and stricture recurrence [1, 2]. Since the resurgence in the use of buccal mucosa grafts (BMG) in substitution urethroplasty in the late 1980s, there has been controversy over which surgical technique is the most appropriate for its application. In experienced hands the results of the ventral and dorsal onlay of BMG for bulbar urethroplasty are the same [2]. BMG has become an ideal urethral substitute because of ease of harvest, surgical handling characteristics, hairlessness, and compatibility in a wet environment and it is early in growth and graft survival; because of these unique characteristics, buccal mucosa has gained popularity in the realm of reconstructive urology. There is paucity of data on this subject in Sub-Saharan Africa; the purpose of this study was to compare ventral and dorsal onlays for bulbar urethroplasty in a low resource setting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
