Dorsal Onlay Buccal Mucosal Graft Urethroplasty for Bulbar Urethral Stricture- Experience Of 20 Cases

Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in bulbar urethral stricture.Materials and Methods: FromJuly 2008 to June 2010, twenty patients with anterior urethral strictures weremanaged by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 weeksand 3 months with history, physical examination, uroflowmetryand retrograde urethrogram (RGU) if required. Patients were furtherfollowed-up at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required. Successfuloutcome 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). Twopatients 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. 23, No.2, October, 2014, Page 175-178

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

Journal of Dhaka Medical College ◽

10.3329/jdmc.v26i1.33990 ◽

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

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Outcome of Buccal Mucosal Graft Urethroplasty in Long Segment Anterior Urethral Stricture

Bangladesh Journal of Urology ◽

10.3329/bju.v19i2.49365 ◽

2020 ◽

Vol 19 (2) ◽

pp. 64-68

Author(s):

Mrinmoy Biswas ◽

Sudip Das Gupta ◽

Mohammed Mizanur Rahman ◽

Sharif Mohammad Wasimuddin

Keyword(s):

Urethral Stricture ◽

Flow Rate ◽

Surgical Outcome ◽

Simple Technique ◽

Anterior Segment ◽

Maximum Flow ◽

Anastomotic Site ◽

Buccal Mucosal Graft ◽

Male Patients

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68

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Is the Tongue an “Alternative Donor Site for Anterior Urethroplasty”?

Bangladesh Journal of Urology ◽

10.3329/bju.v15i1.45606 ◽

2020 ◽

Vol 15 (1) ◽

pp. 11-14

Author(s):

Md Asaduzzaman ◽

Md waliul Islam ◽

Md Nurul Hooda ◽

Tohid Md Saiful Hossain ◽

Md shariful Islam ◽

...

Keyword(s):

Donor Site ◽

Normal Diet ◽

Anastomotic Site ◽

Urethral Strictures ◽

Alternative Donor ◽

Dorsal Onlay ◽

The Mean ◽

A Minor ◽

Urethral Dilation

Objective: To evaluate the effectiveness of a lingual mucosal graft (LMG) urethroplasty for long segment (>2cm) anterior urethral strictures. Materials and Methods: A total of 30 patients underwent urethroplasty for anterior urethral strictures using dorsal onlay of a LMG from January 2009 to December 2010. We selected 21 to 56 years old (mean age 36.6). Stricture length was 22 to 59 mm (mean 36); 14 strictures were in the bulbar urethra, 09 were in the proximal penile and 07 were in both bulbar and penile urethra. Postoperatively all patients were followed with urethrography, uroflowmetry, cystourethrography and urethroscopy after 3weeks, 3 months and 06 months. Successful reconstruction criteria were peak flow rate greater than 15 ml per second and no need for postoperative urethral dilation. Results: The mean period of follow-up was 9 months (range 4-12). The overall success rate at 3rd week and 3rd month was 96.7% and at 6th month was 90%. Three patients developed repeat stricture at the anastomotic site. All the patients were able to resume oral fluid within 24 h, eat soft solid diet in 48–72 h and return to normal diet after 4– 5 days of surgery. No patient suffered from difficulty in opening the mouth, salivation disturbances, or difficulty in protrusion of tongue. Conclusions: LMG is easy to harvest. LMG seems to be associated with less postoperative pain and a minor risk of donor site complications or without any functional or esthetic deficiency. The tongue may be the best alternative donor site. Bangladesh Journal of Urology, Vol. 15, No. 1, Jan 2012 p.11-14

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Dorsolateral Onlay Urethroplasty for the Long Segment Anterior Urethral Stricture: Outcome of 31 Cases

Bangladesh Journal of Urology ◽

10.3329/bju.v18i1.49203 ◽

2020 ◽

Vol 18 (1) ◽

pp. 12-15

Author(s):

Hafiz Al Asad ◽

Md Sharif Shahjamal ◽

Sarforaj Ali Khan ◽

Md Waliul Islam ◽

AKM Zamanul Islam Bhuiyan

Keyword(s):

Urethral Stricture ◽

Kidney Diseases ◽

Successful Outcome ◽

Anastomotic Site ◽

Short Term ◽

Buccal Mucosa Graft ◽

Retrograde Urethrogram ◽

A Prospective Study ◽

Optical Internal Urethrotomy

Objective: This study is designed to observe the short-term outcomes of dorsolateral onlay urethroplasty to treat long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Patients were further followedup at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Successful outcome was defined as normal voiding with no surgical intervention after catheter removal. Results: Mean stricture length was 42.49±12.77 mm (range 24-70 mm) and mean follow up was 8 months (range 6 to 12 months). Three patients were found to develop stricture at anastomotic site, during follow-up and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90.32%. Conclusion: Dorsolateral onlay BMG urethroplasty is feasible for long anterior urethral stricture with good short term surgical outcome. Bangladesh Journal of Urology, Vol. 18, No. 1, Jan 2015 p.12-15

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

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20213942 ◽

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.

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Substitution Buccal Mucosal Graft Urethroplasty for Long Segment Anterior Urethral Stricture : Our Experience in Dorsolateral Onlay Approach

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v20i2.56466 ◽

2021 ◽

Vol 20 (2) ◽

pp. 14-17

Author(s):

Shiba Prasad Nandy ◽

- Md Asaduzzaman ◽

Kamal Uddin Mazumder ◽

Sakhawat Mahamud Khan ◽

Md Monowar Ul Hoque

Keyword(s):

Urethral Stricture ◽

Maximum Flow ◽

Anastomotic Site ◽

Short Term ◽

College Hospital ◽

Term Outcome ◽

Buccal Mucosal Graft ◽

Short Term Outcome ◽

Onlay Technique

Background: Currently the most favorable single stage procedure for management of long segment anterior urethral stricture is dorsal onlay technique of urethroplasty. This required circumferential extensive mobilization of the urethra, which might cause ischemia of urethra in addition to chordee. To evaluate the short term outcome of dorsolateral onlay BMG (Buccal Mucosal Graft) urethroplasty by unilateral urethral mobilization for treatment of long segment anterior urethral stricture Materials and methods: A prospective experimental study from January 2016 to December 2018 is carried out in Department of Urology, Chittagong Medical College Hospital (CMCH) Chattogram, Bangladesh. Total 32 patients of long segment anterior urethral stricture were treated by dorsolateral onlay BMG urethroplasty by unilateral urethral mobilization. Stricture >2cm were included; RGU, MCU and Uroflowmetry were the mainstay of assessment. Success was defined as maximum flow rate >15 ml/s, normal RGU and/ urethroscopy. Failure considered as presence of obstructive symptoms, Qmax < 15 ml/s, stricture on RGU and any post-operative urethral intervention. Results: Mean stricture length was 48.72mm (Range: 30-77mm) and mean follow up time was 22.4months (Range: 12-40 months). Three patients were found to develop stricture at proximal anastomotic site during follow up and required optical internal urethrotomy and considered as failure. 01 patients developed Surgical Site Infection (SSI) which resolved after regular dressing. Success rate was 90.7% Conclusion: Dorsolateral onlay BMG urethroplasty by unilateral mobilization is feasible, safe and easily adoptable for long segment anterior urethral stricture with good short term outcome. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 14-17

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COMPARATIVE ANALYSIS OF VENTRALAND DORSAL BUCCAL MUCOSA GRAFT AUGMENTATION URETHROPLASTY IN STRICTURE BULBAR URETHRA.

10.36106/ijsr/2714230 ◽

2020 ◽

pp. 56-57

Author(s):

Yagyadev Arya ◽

Rahul Goel

Keyword(s):

Buccal Mucosa ◽

Anastomotic Site ◽

Success Rates ◽

Urethral Strictures ◽

Buccal Mucosa Graft ◽

Retrograde Urethrogram ◽

One Year ◽

Rate Of Failure

Objective: To compare long term outcomes of buccal mucosa graft(BMG) augmentation urethroplasty for long-segment bulbar urethral strictures done by placing the graft ventrally and dorsally. Material and Methods: We conducted a single institution retrospective study on 32 patients who underwent BMG augmentation urethroplasty for non traumatic bulbar urethral stricture between January 2010- December 2018. The cases were divided into two groups based on the site of placement of the BMG graft i.e (a) Ventral (n=22) , (b)Dorsal(n=10). Follow-up period was from one year to five years. Patients with failed outcomes underwent Urethroscopy or Retrograde Urethrogram to note the site of recurrence of stricture. Results: Out of 32 cases 26 (81%) were successful and 6 (19%) failed.The success rates for ventral and dorsal BMG augmentation procedures were 81% and 70%,respectively(p=0.45).Among 6 failed cases 3 (9%)cases had stricture at proximal anastomotic site,2 (2%)cases at distal anastomotic site& 1 (1%)case at pan graft site(p=0.08). Conclusion: The overall success rate for BMG augmentation urethroplasty is equal for all techniques.Dorsal onlay urethroplasty provides better exposure of proximal anastomotic site thus it is associated with minimum proximal anastomotic site recurrence rates.Patient with extensive spongiofibrosis and long segment strictures had higher rate of failure.

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