Buccal mucosa urethroplasty for bulbar urethral strictures

ABSTRACT

Objectives: Urethroplasty with the buccal mucosa graft is an excellent option for the treatment of urethral stricture disease. The authors report their 10-year experience with buccal mucosa graft urethroplasty by the dorsal and ventral approach. Patients and Methods: From June 1994 to May 2003; 67 patients with bulbar urethral stricture underwent buccal mucosa urethroplasty. A free graft of buccal mucosa was used as an onlay; ten patients were operated by the ventral approach and the remaining 57 by the dorsal approach. After the bulbar urethra is exposed; we perform a dorsal endoscopic cold knife urethrotomy until the urethra is fully opened. After measurement of the defect; the graft is harvested from the lower lip and sutured to the urethra and to the corpora cavernosa. A transurethral grooved catheter and suprapubic drainage are left for 7 and 14 days; respectively. Results: The median follow-up was 58 months (range 12 - 110). Recurrence of the stricture occurred in 4(3/67) of the patients with a recurrence rate of 2/10 (20) and 1/57 (2) for the ventral and dorsal onlay patients; respectively. The overall complication rate was 9/67 (13). Conclusions: Buccal mucosa urethroplasty provides a high long-term success rate for the treatment of bulbar urethral strictures. The dorsal onlay may be superior to the ventral onlay approach: