Objective: To report detailed technique and results of one stage dorsal onlay buccal mucosa graft for repair of anterior urethral strictures. Patients and methods: A total of 45 males with anterior urethral stricture ≥ 2.5 cm not amenable for excision and primary anastomosis. All patients underwent one-stage dorsal onlay buccal mucosa urethroplasty. Their ages ranged from 14 to75 years (mean of 35.5 yr). A successful outcome means normal voiding pattern without any post-operative intervention. Results and limitations: The stricture was iatrogenic in 15 (33.3%) cases, idiopathic in 12 (26.7%), traumatic in 10 (22.2%) cases, and post inflammatory in 8 (17.8%) cases. The mean operative time was 158 minutes. The mean stricture length was 5.6 cm (range: 2.5-16 cm), while, the mean graft length was 7.2 cm (range: 4.5-18cm). The mean follow-up period was 36 months (range 27-48). Overall success rate was 88.9% (40/45). Four patients developed stricture Recurrence. Two of them had annular short bulbar stricture for which direct vision internal urethrotomy was performed and the other two cases needed redo urethroplasty. One patient had dehiscence of glans penis after repair of pan urethral stricture and repair was required. This case and the previous four cases were considered failures (11.1%). The most common complication was urinary tract infection (24.4%). All patients returned to normal diet within 48 hours without oral complications. Conclusion: Meticulous repair of anterior urethral strictures using dorsal onlay buccal graft is technically easy with high success rate. Buccal graft harvesting is simple and easy procedure.
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