383 RECONSTRUCTION OF EXTENDED URETHRAL STRICTURES WITH BUCCAL MUCOSAL GRAFT. SUCCESS RATES AFTER 60 MONTHS OF FOLLOW UP: ANALYSIS OF 184 PATIENTS

2010 ◽  
Vol 9 (2) ◽  
pp. 143
Author(s):  
A. Pandev ◽  
L. Dobkowicz ◽  
J. Beier ◽  
H. Keller
Keyword(s):  
Success Rates ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Graft Success

scholarly journals Buccal One-Stage Mucosal Graft Urethroplasty for Urethral Stricture. Results of 10 Years of Experience.

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Gezim Galiqi ◽  
Artan Koni ◽  
Flamur Tartari ◽  
Albert Pesha ◽  
Shpetim Ymeri ◽  
...  
Keyword(s):  
Success Rate ◽  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Dorsal Surface ◽  
Success Rates ◽  
Lower Lip ◽  
Bulbar Urethra ◽  
Urethral Strictures ◽  
Buccal Mucosa Graft

Aim: Representing our data regarding use of buccal mucosa for treatment of recurrent urethral stricture. Evaluating effectiveness of buccal graft for reconstruction of urethral segment both penile and bulbar urethra. Materials and methods: We repaired 95 urethral strictures with buccal mucosa grafts from 2004 to 2015. Mean patient age was 39 years. The etiology of stricture was unknown in 54% of cases in other cases ischemia, trauma, instrumentation was the reason. 96% had undergone previous urethrotomy or dilation. The buccal mucosa graft was harvested from lower lip mostly. Mean graft length was 3.8 cm. The graft was placed on the ventral and dorsal bulbar urethral surface in 61 and 34 cases, respectively. In pendulous urethra we routinely use the dorsal graft the Asopa inlay graft or Barbagli onlay graft. Clinical outcome was considered a success or failure at the time that any postoperative procedure was needed, including dilation. Mean follow-up was 36 months (range 16 to 62). Results: We had a success rate of 77% with dorsal inlay or onlay flap for pendulous urethra inferior than ventral graft used for bulbar urethra which was 81% success rate. Conclusions: In our experience the placement of buccal mucosa grafts into the ventral or dorsal surface of the bulbar urethra showed an acceptable success rates 81% and 77% respectively. Longer times of follow up is need to see if the results deteriorated more.

scholarly journals Role of dorsal onlay buccal mucosal graft urethroplasty for long anterior urethral strictures

2021 ◽  
Vol 9 (10) ◽  
pp. 3110
Author(s):  
Vedamurthy Reddy Pogula ◽  
Ershad Hussain Galeti ◽  
Venkatesh Velivela ◽  
Bhargava Reddy Kanchi
Keyword(s):  
Statistical Difference ◽  
Age Groups ◽  
Factors Affecting ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Significant Difference ◽  
Dorsal Onlay ◽  
The Mean

Background: Treatment of the urethral strictures is challenging and with appropriate evaluation preoperatively and surgery planning it is possible to achieve good results. The objective of the study was to evaluate the efficacy of dorsal onlay buccal mucosal graft urethroplasty in treating long anterior urethral strictures.Methods: Between August 2018 to July 2019 a total of 25 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤ 7 cm, and > 7 cm), and site of the stricture were assessed as the factors affecting the success rate.Results: The clinical outcome as Success was defined as the patient not needing any form of urethral instrumentation postoperatively. The mean follow-up period was 18 months. Of 25 patients, 22 (92%) were successful and 3 (8%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p=0.21 and p=0.444). The statistical difference was significant for the site and length of the stricture by means of success (p=0.005 and p=0.025).Conclusions: Our results show stricture length and localization are the most important variables for good success. Because of less failure rate, single-stage dorsal onlay buccal mucosal graft urethroplasty may be offered as an alternative to staged urethroplasty in case of long urethral strictures.  

scholarly journals Dorsal Onlay Buccal Mucosal Graft Urethroplasty for Bulbar Urethral Stricture- Experience of 20 Cases

2017 ◽  
Vol 26 (1) ◽  
pp. 8-11
Author(s):  
Hafiz Al Asad ◽  
AKM Musa Bhuiyan ◽  
Md Nazmul Islam ◽  
Uttam Karmaker ◽  
Md Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Successful Outcome ◽  
Anastomotic Site ◽  
Medical College ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Onlay Technique ◽  
Retrograde Urethrogram ◽  
Dorsal Onlay ◽  
Optical Internal Urethrotomy

Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in bulbar urethral stricture.Materials and Methods: From July 2008 to June 2010, twenty patients with anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required. Patients were further followed-up at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required. Successful outcome was defined as normal voiding with no surgical intervention after catheter removal.Results: Mean stricture length was 3.5 ± 0.8 cm and mean follow up was 12 months (range 6 to 24 months). Two patients were found to develop stricture at anastomotic site, during followup and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90%.Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 8-11

scholarly journals Buccal mucosal graft urethroplasty in the treatment of urethral strictures: a prospective study

2021 ◽  
Vol 10 (1) ◽  
pp. 180
Author(s):  
Chetan Baragi ◽  
Raveendra Totad ◽  
Shankarsnehit Patil ◽  
Nandini Takkalaki
Keyword(s):  
Prospective Study ◽  
Surgical Repair ◽  
Primary Anastomosis ◽  
Standard Procedure ◽  
The Past ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
A Prospective Study ◽  
Graft Shrinkage

Background: Anterior urethral strictures develop due to a process of fibrosis and cicatrix formation of the urethral mucosa and the surrounding tissues. Its surgical management is a challenging problem, and has changed dramatically in the past several decades. Open surgical repair using grafts has become the gold standard procedure for anterior urethral strictures that are not amenable to excision and primary anastomosis. Oral mucosa harvested from the inner cheek (buccal mucosa) is an ideal material, and is most commonly used for substitution urethroplasty. Objective of current study was to establish the efficacy of the buccal mucosal graft urethroplasty by different onlay techniques in anterior urethral strictures.Methods: The study was a prospective study, done between August 2009 and December 2011. 25 cases of long anterior urethral strictures were managed by onlay urethroplasty by different techniques. Follow up ranged from 8-20 months.Results: 3 patients lost follow up after first visit. Post operative uroflowmetry was done in all patients after 1 month at the time of first follow up visit. Of 25 cases 21 (84%) were successful and 4 (16%) failed.Conclusions: In our study we have found that buccal mucosal graft can be safely used for substitution urethroplasty in all long anterior urethral strictures including cases with balanitis xerotic obliterance. It was very efficient in terms of less graft shrinkage or contracture as it is a full thickness graft.

scholarly journals Dorsally Placed Buccal Mucosal Graft Urethroplasty in Treatment of Long Urethral Strictures Using One-Stage Transperineal Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Kamyar Tavakkoli Tabassi ◽  
Alireza Ghoreifi
Keyword(s):  
Success Rate ◽  
Operative Procedure ◽  
Transmitted Disease ◽  
Lichen Sclerosus ◽  
Sexually Transmitted ◽  
One Stage ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
The Mean

Objectives. To evaluate the results of one-stage buccal mucosal urethroplasty in treatment of long urethral strictures. Methods. This retrospective study was carried out on 117 patients with long urethral strictures who underwent one-stage transperineal urethroplasty with dorsally placed buccal mucosal grafts (BMG). Success was defined as no need for any intervention during the follow-up period. Results. Among 117 patients with mean age of 39.55±15.98 years, the strictures were located in penile urethra in 46 patients (39.32%), bulbar urethra in 33 (28.20%) and were panurethral in 38 (32.48%). The etiology of the urethral stricture was sexually transmitted disease (STD) in 17 (14.53%), lichen sclerosus in 15 (12.82%), trauma in 15 (12.82%), catheterization in 13 (11.11%), transurethral resection (TUR) in 6 (5.13%), and unknown in 51 (43.59%). The mean length of strictures was 9.31±2.46 centimeters. During the mean followup of 18.9±6.7 months success rate was 93.94% in bulbar strictures, 97.83% in penile strictures, and 84.21% in panurethral strictures (P value: 0.061). Conclusions. The success rate of transperineal urethroplasty with dorsally placed buccal mucosal grafts is equal in different sites of strictures with different etiologies. So reconstruction of long urethral strictures may be safely and effectively performed at a simple single operative procedure using this method of urethroplasty.

scholarly journals A case series of standard surgical management of bulbo-membranous stricture

2017 ◽  
Vol 4 (4) ◽  
pp. 1299
Author(s):  
Dhananjay Selukar ◽  
Amit Narayan Pothare ◽  
Kunal Meshram ◽  
Vinay Rahangdale ◽  
Nikhilesh Jibhkate ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Long Term Results ◽  
Tension Free ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
End To End ◽  
Anastomotic Urethroplasty

Background: Urethral stricture is an acquired permanent narrowing of the urethra impeding the flow of urine during micturition. It is one of the oldest urological diseases, and its treatment remains a challenge for urologists. Urethral stricture disease affects about 300 per 100,000 men. Most common causes are trauma and infections in developing countries and idiopathic in developed countries. Treatment options for short bulbar urethral strictures include dilatation, direct visual internal urethrotomy and anastomotic urethroplasty. Excision and end to end anastomosis (anastomotic urethroplasty) for short bulbo-membranous urethral strictures and buccal mucosal graft gives excellent long term results with reduced recurrence rate.Methods: Sixty-three patients who had undergone anastomotic urethroplasty from 2013 to 2016 at Government Medical College and Superspeciality Hospital, Nagpur, Maharashtra, India Department of Urology were included in the study. For strictures less than 2cm, excision of stricture and anastomosis done, while for stricture more than 2cm buccal mucosal grafting done over 16 F Foleys catheter. Postoperative follow up done up to 1 year.Results: The total number of patients included is 63 and study conducted between January 2013 to December 2016. End to end urethroplasty was done in 41 patients and had mean duration of surgery of about 120 minutes, while buccal mucosal grafting was done in 22 patients. Age ranges from 14 to 78 years with highest incidence of stricture was seen after 5th decade of life, mainly due to iatrogenic causes of previous instrumentation and post TURP surgery. Strictures in younger adults are mainly as a result of trauma by fall astride injury and pelvic fractures and seen during 3rd and 4th decade of life. Most common length of stricture observed was 1-2cm in about 65.07% and mainly occurred due to post urethral procedures. Long strictures more than 2cm were mainly because of trauma in about 35%. Seven patients had recurrence in follow up, out of which 2 managed conservatively by repeated dilatation and 5 patients needed reoperation.Conclusions: The present results suggest that in patients with strictures too long to be excised and re-anastomosed a tension-free buccal mucosal graft provides better results. However, in patients with short strictures, in whom a completely tension-free anastomosis can be achieved, direct end-to-end anastomosis remains good option.

Outcome of Dorsolateral OnlAy OMG Urethroplasty for Anterior Urethral Stricture

2020 ◽  
Vol 16 (2) ◽  
pp. 37-42
Author(s):  
Tohid Md Saiful Hossain ◽  
Md Asaduzzaman ◽  
Md Afzalur Rahman ◽  
Md Nasir uddin ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Urethral Stricture ◽  
Donor Site ◽  
Maximum Flow ◽  
Successful Outcome ◽  
Term Outcome ◽  
Lower Lip ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft

Objective: To determine the feasibility, safety, efficacy and short term outcome of using new surgical technique for repair of anterior urethral stricture Introduction: The conventional approach for management of long segment anterior urethral stricture is a two stage Johansons repair along with the use of free grafts if required. Now a days the preferred management of urethral stricture involving long segments of anterior urethra is dorsal only oral mucosa Augmentation urethroplasty which requires circumferential mobilization of urthera that might cause ischaemia of urethra in addition of chordee. For that we adopted new technique (kulkarnis) of dorsolateral onlay buccal mucosal graft one sided anterior urethroplasty in which only unilateral urethral mobilization done through perineal approach. Materials and Methods: A total of 50 patients underwent urethroplasty for anterior urethral strictures using dorsolateral onlay BMG from April 2010 to December 2012 at NIKDU, JBFH, BSMMU and BDM Hospital. We selected 16 to 70 years old male (mean age 39 years) underwent a one-sided dorsolateral oral mucosal graft urethroplasty. The mean (range) stricture length was 6.5 (4.5-9) cm in patients with single bulbar urethral involvement and 10.5 (8.5–15.0) cm in patients with panurethral strictures. Free graft was taken from oral mucosa either lower lip or cheeks. Follow up was done by uroflowmetry at 3rd week, after removal of penile catheter and repeat at 3rd and at 6th month. In addition to uroflometry – RGU & MCU was done at 3rd month and Urethrocystoscopy was done at 6th month follow up. The results were classified into the following outcomes. Success was defined as a maximum flow rate of >10 ml/sec, normal RGU, and/or urethroscopy (with a 19 Fr. sheath). Failure was defined as the presence of obstructive urinary tract symptoms, Qmax <10 ml/sec, stricture diagnosed on retrograde urethrogram/ urethroscopy, and the need for any postoperative urethral intervention. Result: The overall follow up was 12-30 months. Of the 50 patients 45 (90%) had a successful outcome and 5(12%) had failure. 3 failure treated by OIU and 2 by meatal dilatation. No significant donor site defect was observed. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.37-42

scholarly journals Reconstruction of the long urethral strictures with the buccal mucosal free graft

2014 ◽  
Vol 61 (1) ◽  
pp. 41-44
Author(s):  
Ivan Ignjatovic ◽  
Dragoslav Basic ◽  
Jablan Stankovic ◽  
Milan Potic ◽  
Ljubomir Dinic
Keyword(s):  
Urethral Reconstruction ◽  
Graft Material ◽  
Free Graft ◽  
Residual Symptoms ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Exact Evaluation ◽  
Primary Graft Failure ◽  
One Year

Introduction: Reconstruction of the long urethral strictures is a difficult task in urology. The most frequently used method is augmentation with the free buccal mucosal graft. Material and methods: Restrospective analysis of 57 patients with the long urethral stricture was performed. All patients were evaluated endoscopically and radiologically before the surgery. Buccal mucosal graft harvested from the inner side of the cheek (unilateral or bilateral) was used for the urethral reconstruction in all patients. Follow-up was one year. Results: Complete follow up is achieved in 44/57 (77.2%)patients. The most important etiology of the strictures was previous iatrogenic trauma (instrumentation). The strictures were the most frequently located in the bulbar urethra. Preoperative exact evaluation of the stricture length was possible in only 35/57 patients (61.4%). Overall success rate of the surgery was 38/44 (86.3%). Complications occurred in 6/44 (13.7%) of patients-primary graft failure and urinary fistula. Mean preoperative IPSS was 19,2?5,2, and postoperative 10.3?3,2 (p<0.0001). IPSSQOL was 4.9?3.7 before the surgery, 2.9?1,1 after the surgery(p<0.001). Persistent urinary infection was present in 12/44(27.2%) patients. Conclusion: Buccal mucosal free graft could be successfully used in the reconstruction of long urethral strictures. However, complications are not uncommon, and residual symptoms still exist after the surgery, and could not be neglected.

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