The use of a buccal graft for urethroplasty of urethral strictures in men

Introduction. The urethroplasty of the urethral stricture disease is still a severe problem for surgeons. The aim of this study is to evaluate own results of buccal mucosa graft urethroplasty (BMGU) for the treatment of urethral stricture. Aim. Evaluation of own results of urethroplasty with a graft of the oral mucosa in the treatment of urethral strictures. Materials and methods. Between 01.08.2014 and 01.06.2020 we treated 136 patients with urethral stricture at our Medical Centers, where we provided buccal mucosa graft urethroplasty for bulbar and penile urethra. Results. The bulbar stricture was found among 105 patients of 136 (77,1 % cases), in which 64 had stricture in proximal part and 41 – in distal part of the urethra, 19 patients – in penile urethra and the other part had panurethral lesion. The median length of the stricture was measured as 3,8 ± 0,6 sm in the first three groups, and in the last group it was 10,4 ± 1,5 sm. At a median follow-up of 16,3 months 87,5% of patients in the first group, 90,2 % in the second, 84,2 % in the third and 83,3 % in the fourth group had no stricture recurrence and were satisfied with BMGU. Conclusion. For patients with urethral stricture disease, BMGU offers excellent success, morbidity with different techniques and methods, which statistically are equal to each other.

Staged Buccal Mucosa Graft Urethroplasty for Proximal Hypospadias in Children: A Short- to Mid-Term Follow-Up Retrospective Study

Introduction The aim of this study is to report our experience with modified staged buccal mucosa graft urethroplasty for the repair of proximal hypospadias in children and adolescents. Materials and Methods A total of 183 patients were treated at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between 2010 and 2019. The patients were grouped according to age: (1) within 1.5-year-old group, (2) prepuberty group (Tanner stage 1), and (3) puberty group. Results In total, 153 patients were included in this study. Thirty-six patients had complications: seven after stage one; 29 after stage two; one patient had two complications. Maximum flow rates were 11.80 ± 1.46 mL/s in the 1.5-year-old group, 13.24 ± 2.61 mL/s in the prepuberty group, and 13.60 ± 2.20 mL/s in the puberty group (p = 0.199). Average flow rates were 6.86 ± 1.37, 7.94 ± 1.74, and 7.88 ± 1.22 mL/s, respectively (p = 0.203). The optimal hypospadias objective scoring evaluation score of 16 was seen in 117 patients (76%), the score of 15 in 23 patients (15%), 14 in 10 (7%), and 13 in 3 patients (2%). Patients with an uncomplicated treatment (no complication) had a higher clinical outcome than patients with a complication (15.8 ± 0.53 vs. 15.3 ± 0.97, with or without complication, p = 0.000). Multivariable analyses showed that previous treatment was closely related to the complication rate (p = 0.016). Conclusion The modified procedure allows for two-stage repair of proximal hypospadias with good results with a low complication rate and good functional results. Delaying operation did not increase complication rates in our research.