Reconstructive Management with Buccal Urethroplasty

Abstract

We present the historical evolution of the use of buccal mucosa in reconstructive surgery, from the first application in ophthalmology to paediatric surgery and, finally, urethral surgery. This process spanned 99 yr, from 1894 to 1993. The harvesting of buccal mucosa from the cheek requires careful preoperative patient evaluation and selection. To avoid postoperative complications related to the harvesting site, we provide some suggestions based on a large series of patients. The use of a one- or two-stage repair procedure in penile urethroplasty is discussed, and some step-by-step surgical techniques are suggested. The reconstruction of the bulbar urethra using buccal mucosa in traumatic and nontraumatic strictures is also discussed, and different techniques are presented. Finally, appraisal and discussion of some challenging topics (eg, evidence for efficacy, complications, implications, worldwide use) concerning the use of buccal mucosa for urethral stricture reconstruction are presented based on the current literature. Patient summaryWe looked at the history and evolution of the use of buccal mucosa for reconstructive urethral surgery and found that harvesting the buccal mucosa from the cheek is a safe procedure. The use of buccal urethroplasty represents the gold standard in the management of patients with anterior urethral strictures.