Single-Stage Reconstruction of Fossa Navicularis Strictures Using a “Sliding-T” Dorsal Inlay Urethroplasty With Buccal Mucosal Graft

Background: Hypospadias surgery has developed into a well-defined art and science. Surgeons dealing with this anomaly should have detailed understanding of various basic surgical principles and experience with delicate, precise optically assisted techniques and maintain a clinical workload that is sufficient to obtain consistently good results. Objective of this study was to evaluate the outcome of using buccal mucosal graft for single stage repair in adult hypospadias cripples.Methods: All patients with prior failed hypospadias repair after multiple surgeries presenting in MLN Medical College, Allahabad were included in study. Dorsal onlay buccal mucosa graft with parallel turn over flap from penile skin for ventral surface method was used.Results: Total 20 patients were included in study. Among these 12 patients presented with complete dehiscence of repair, 5 patients presented with multiple urethrocutaneous fistulas, 3 patients presented with extensive stricture formation. Same surgeon performed procedure of dorsal onlay buccal mucosa graft urethroplasty to reduce the bias. Success rate of dorsal onlay substitution free buccal mucosal graft urethroplasty in single stage is affected by scarring of surrounding penile skin. Most common complication related to donor site are transient pain and swelling and to graft site are stricture and fistulas.Conclusions: Single stage repair with buccal mucosal graft in hypospadias cripple patients is an excellent free graft urethroplasty in cases with prior failed primary repair of hypospadias, in whom the preputial skin was lacking or insufficient and a longer urethral tube needed to be constructed.

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Outcome of Single Stage OMG Urethroplasty by Kulkarni Technique in Comparison With Johanson’s Staged Urethroplasty for Management of Pan-Urethral Stricture

Bangladesh Journal of Urology ◽

10.3329/bju.v19i2.49368 ◽

2020 ◽

Vol 19 (2) ◽

pp. 78-84

Author(s):

Md Shariful Islam ◽

Md Asaduzzamman ◽

Kaiser Ahmed ◽

MA Salam ◽

Md Shawkat Alam

Keyword(s):

Postoperative Complications ◽

Clinical Outcome ◽

Urethral Stricture ◽

Operative Procedure ◽

Single Stage ◽

Buccal Mucosal Graft ◽

Group A ◽

Group B ◽

Final Calculation

Purpose: To observe the outcome of single stage buccal mucosal graft and Johanson’s staged urethroplasty for treatment of pan- urethral stricture. Materials and Methods: A total of 60 patients with an average age of 42 years (21-55) underwent OMG urethroplasty and Johanson’s staged urethroplasty between March 2008 to September 2015 for pan-urethral stricture of different etiology. OMG was always harvested from cheek using 2 team approaches. Graft was placed using Kulkarni technique. Clinical outcome was considered success or failure if any post operative procedure needed. Mean follow up was 45 month (6-95) Results: Total 60 patients were included for final calculation, 31 patients with buccal mucosal graft (Group A) and 29 patients with Johanson’s staged urethroplasty (Group B) were followed up for average 45 months. Success rate of group A was 93.5% at 3 months and 77.4% at 3 years and in group B 65.5% at 3 months and 44.8% at 3 years follow up which is statiscally significant (p <.05). Postoperative complications were significantly higher in group-B. Conclusion: Repair of pan-urethral stricture in a single-stage OMG by Kulkarni technique is simple, fast, safe, effective and reproducible in the hand of any surgeon. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.78-84

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