Dorsal onlay buccal mucosal graft urethroplasty for anterior urethral stricture / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the efficacy and safety of dorsal onlay buccal mucosa urethro-plasty for the treatment of long anterior urethral stricture. Methods From October 2005 to SeDtem-ber 2007,57 patients(17-52 years old)underwent buccal mucosal dorsal onlay urethroplastv for the treatment of anterior urethral stricture.The mean urethral stricture length was 3.0cm(2.5-7.0 cm).Previously,29(51%)patients had experienced one direct vision internal urethrotomy(DVIU),20(35%)patients had accepted twice DVIU and 8(14%)patient had 3 times DVIU for the treatment of urethral stricture.All patients recurred urethral stricture after DVIU.The length of urethral stric-ture was measured by combined retrograde urethrography and voiding cystourethrography before ure-throplasty.All patients accepted urethroplasty at more than 6 months after last failed surgery.Buccal mucosa was harvested from right cheek.The urethra was exposed and dors'al side was rotated to out-side. A longitudinal incision was made on urethra. Buccal mucosal free grafts were sutured to the open edges of urethra with 6-0 absorbable suture. 1 8 F silicon fenestrated urethral catheter was Dlaced and kept for 4 weeks. Urethrography was used at 4 weeks and 3 months after the urethroplastv,and thenevery 6 months to evaluate the urethral recovery.Dysuria and urethral caliber less than 1 6 F which was confirmed by urethrography and urethroscopy were regarded as stricture recurrence. Resuits The mean fellow-up time were 11.2 months(1-23 months).Fifty-four(95%) patients remained stricture free.Three(5%)patients recurred at the 2 to 3 months after the operation and were treated with DVIU.Three patients had wound infection and recovered without other complication.There was no fistula,diverticulum in all patients.The pain of cheek lasted for 2 5 days(average 2.3 days).No case had hypoesthesia of cheek,obstruction of stenseffs duct or cheek scar.Conclusions Dorsal on-1ay buccal mucosal urethroplasty for long anterior urethral stricture provides stable results with few and acceptable complications.