Outcomes of Ventral Onlay Buccal Mucosal Graft Urethroplasty in Bulbomembranous Urethral Strictures Post-transurethral Resection of the Prostate

Abstract

ObjectivesTo evaluate the outcomes of Ventral Onlay Buccal Mucosal Graft Urethroplasty (VOBMGU) in bulbomembranous urethral strictures after transurethral resection of the prostate (TURP). MethodsAfter approval of the institutional ethical committee, we retrospectively examined the database of patients diagnosed with PTS and treated by VOBMGU from January 2020 to January 2022. The patients were evaluated by retrograde urethrogram (RUG) and voiding cystourethrogram (VCUG). Follow-up evaluation included assessment of lower urinary tract symptoms (LUTS), physical examination, uroflowmetry (Q-max and International Prostate Symptom Score) 3, 6, and 12 months of follow-up. ResultsA total of 30 patients underwent VOBMGU for bulbomembranous PTS were included. The median age of the patients was 63.5 (11.25). The median stricture length was 3.5 (1.5) cm. During follow-up, the mean Q-max significantly increased to 21.1 ± 5.5 ml/s (p < 0.0001), 20.1 ± 5.4 ml/s (p<0.001), and 19.1 ± 5.3 ml/s (p<0.003) at 3, 6, and 12 months respectively. IPSS significantly decreased to 8.93 ± 6.37 at the 12-month follow-up mark (p<0.0001). Three patients developed stricture recurrence and two patients developed post-operative urinary incontinence. ConclusionVOBMGU in cases of bulbomembranous urethral PTS offered excellent functional outcomes with low stricture recurrence and minimal risk of incontinence. Further prospective studies are warranted to confirm the results.