Buccal Mucosa Urethroplasty for the Treatment of Bulbar Urethral Strictures

Pansadoro, Vito; Emiliozzi, P.; Gaffi, Marco; Scarpone, Paolo

doi:10.1016/s0022-5347(05)68938-0

Cited by 62 publications

(20 citation statements)

References 9 publications

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“…Since long, genital skin (prepuce or dorsal penile skin) is used 15,16 and more recently, buccal mucosa has been proposed and has become very popular. [17][18][19] With similar follow up and stricture length, the failure rate of preputial skin or buccal mucosa was exactly equal in our series. The failure rate of dorsal penile skin was significantly higher.…”

Section: Discussionsupporting

confidence: 74%

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Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

2010

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Objectives: To evaluate the outcome of different techniques of urethroplasty and to assess the quality of an in-home algorithm. Methods: Two hundred fifty-two male patients underwent urethroplasty. Mean patient's age was 48 years (range 1-85 years). Data were analyzed for the failure rate of the different techniques of urethroplasty. An additional analysis was done based on an in-home algorithm. Results: Median follow up was 37 months (range: 6-92 months). Global failure rate was 14.9%, with an individual failure rate of 11.7%, 16.0%, 20.7% and 20.8% for anastomotic repair, free graft urethroplasty, pedicled flap urethroplasty and combined urethroplasty, respectively. In free graft urethroplasty, results were significantly worse when extrapreputial skin was used. Anastomotic repair was the principle technique for short strictures (83.3%), at the bulbar and posterior urethra (respectively 50.8 and 100%). Free graft urethroplasty was mainly used for 3-10 cm strictures (58.6%). Anastomotic repair and free graft urethroplasty were more used in case of no previous interventions or after urethrotomy/dilation. Pedicled flap urethroplasty was the main technique at the penile urethra (40.7%). Combined urethroplasty was necessary in 41 and 47.1% in the treatment of, respectively, >10 cm or panurethral/multifocal anterior urethral strictures and was the most important technique in these circumstances. Two-stage urethroplasty or perineostomy were only used in 2% as first-line treatment but were already used in 14.9% after failed urethroplasty. Conclusion: Urethroplasty has good results at intermediate follow up. Different types of techniques must be used for different types of strictures.

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Section: Discussionsupporting

confidence: 74%

“…2,5 The dorsal placement of the graft has been described by Barbagli et al, 21 and some authors suggest this technique to be superior. 18,22 Our data however, showed equal failure rates for the ventral or dorsal location. There is a difference between the use of the technique in the penile vs the bulbar urethra.…”

Section: Discussioncontrasting

confidence: 46%

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

2010

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“…In other studies, tubularized buccal mucosal grafts produced successful results in 55-60% of reconstruction, urethral strictures in 40-45% and fistula in 6-45% [26][27][28]. Also, Mehrsai et al [7] reported a 76.5% success rate in a buccal mucosal graft urethroplasty after 28 months of follow-up.…”

Section: Discussionmentioning

confidence: 89%

Application of amniotic membrane as xenograft for urethroplasty in rabbit

et al. 2009

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“…Over a median (range) follow-up of 34 (8-72) months, 66 (88%) patients with a one-stage reconstruction (14/16 pendulous; 37/41, 90%, bulbar; 15/16 pan-urethral) remained stricture-free. The mean (range) time to recurrence was 9.4 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) months. Of the nine recurrent strictures, six were managed by one-stage optical urethrotomy and three required a repeat urethroplasty.…”

Section: Resultsmentioning

confidence: 99%

Buccal mucosal urethroplasty: a versatile technique for all urethral segments

et al. 2005

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OBJECTIVETo present our experience with buccal mucosa urethroplasty for substitution of all segments of the anterior urethra, as the buccal mucosal graft (BMG) has emerged as the tissue of choice for single-stage reconstruction of bulbar urethral strictures, but its use for reconstructing meatal, pendulous and panurethral strictures has not been widely reported. PATIENTS AND METHODSBetween January 1998 and October 2003, 92 patients had a BMG substitution urethroplasty at our institution; 75 had a single-stage dorsal onlay BMG urethroplasty (bulbar 41, pendulous 16 and pan-urethral 18; six combined penile skin flap and BMG) and 17 (pendulous five, pan-urethral 10, bulbar two) a two-stage urethroplasty. Recurrence rates, complications and cosmetic outcomes were analysed retrospectively. RESULTSOver a median (range) follow-up of 34 (8-72) months, 66 (88%) patients with a one-stage reconstruction (14/16 pendulous; 37/41, 90%, bulbar; 15/16 pan-urethral) remained stricture-free. The mean (range) time to recurrence was 9.4 (3-17) months. Of the nine recurrent strictures, six were managed by one-stage optical urethrotomy and three required a repeat urethroplasty. In patients who had a staged procedure, after a mean follow-up of 24.2 (9-56) months, one had complete graft loss, requiring re-grafting, five required stomal revision after stage 1, and only two (12%) developed a recurrent stricture after the two-stage urethroplasty. CONCLUSIONA one-stage dorsal onlay BMG urethroplasty provides excellent results for strictures involving any segment of the anterior urethra. The BMG appears to be the most versatile urethral substitute, as it can be successfully used for both one-and two-stage reconstruction of the entire anterior urethra.

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Buccal Mucosa Urethroplasty for the Treatment of Bulbar Urethral Strictures

Abstract: Preliminary results of urethroplasty for bulbar urethral strictures with a dorsal onlay graft of buccal mucosa are excellent. Longer followup is needed to evaluate definitive results.

Cited by 62 publications

References 9 publications

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

Application of amniotic membrane as xenograft for urethroplasty in rabbit

Buccal mucosal urethroplasty: a versatile technique for all urethral segments

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