Dorsal Buccal Mucosal Graft Urethroplasty by a Ventral Sagittal Urethrotomy and Minimal-Access Perineal Approach for Anterior Urethral Stricture

Gupta, Narmada P.; Ansari, M.S.; Dogra, PN; Tandon, Sanjeev

doi:10.1016/s0022-5347(05)01035-9

Cited by 17 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another Indian study [9], found dorsal buccal mucosa graft urethroplasty via a minimal access perineal approach did not require urethral dissection and mobilization thus preserving the blood supply .…”

Section: Discussionmentioning

confidence: 99%

Outcome of Dorsal Onlay Buccal Mucosa Substitution Urethroplasty in Long Strictures of Anterior Urethra

Jain

Talwar

2007

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Original Article IntroductionT he surgical treatment of adult anterior urethral strictures is constantly evolving. However in recent times there has been a wider use of buccal mucosal graft versus other substitutes such as genital or extragenital skin. We present our experience of dorsal onlay urethroplasty using buccal mucosal graft in long segment stricture of the anterior urethra. Material and MethodsIt is a prospective study, involving 12 patients of long stricture of the anterior urethra who underwent buccal mucosa graft dorsal onlay urethroplasties between 2003 and 2005. Preoperatively, demographic data and clinical features were recorded. Uroflowmetry was done in patients who were not in retention. Retrograde urethrogram (RGU) and micturiting cysto-urethrogram (MCU) were obtained in all patients (Figs. 1,2). All patients underwent dorsal onlay buccal mucosa urethroplasty, nine by Barbagli's technique, two by ventral saggital urethrotomy approach and one underwent two staged procedure. The Barbagli's technique involved mobilisation of strictured urethra through perineal approach, dorsal splitting of the diseased urethra, placement of prepared graft on perineal cavernosal bed, fixing of graft by quilting sutures and suturing of graft edges to urethral edges with 4/0 vicryl over a 16 Fr silicone catheter [1]. The ventral saggital urethrotomy involved degloving of penis from circumcoronal part to the root of penis at the level of Buck's fascia, ventral saggital urethrotomy, incision of dorsal urethra in the mid line through the strictured area, suturing of buccal mucosa strip in dorsal urethrotomy using 4/0 vicryl and giving few quilting sutures to fix the graft in its bed and closure of urethra over a 16 Fr silicone catheter. A 1-1.5 cm strip of buccal mucosa was harvested after sub mucosal injection of 1:1,00,000 adrenaline, to facilitate dissection and reduce bleeding. Subdermal fat was removed and the graft trimmed to size and fenestrated. The catheter was left in place for 2-3 weeks. Post operatively, at least one uroflowmetry, urine

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome of Dorsal Onlay Buccal Mucosa Substitution Urethroplasty in Long Strictures of Anterior Urethra

Jain

Talwar

2007

Medical Journal Armed Forces India

View full text Add to dashboard Cite

show abstract

“…7 Long anterior urethral stricture (> 2 cm long) should be treated with substitution urethroplasty to avoid postoperative chordee formation. 3 Substitution urethroplasty may be a patch graft or tube graft. 8,9 Free skin grafts used as patch or tube graft in substitution urethroplasty are associated with complications like graft shrinkage, diverticulum formation and recurrent stricture, although results of patch grafts are better than tube grafts 10,11,12 Humby was the first to use buccal mucosa for urethral reconstruction in a series of single stage hypospadias repair.…”

Section: Discussionmentioning

confidence: 99%

“…2 Patients with long strictures (> 2 cm in length) are not suitable for end-to-end urethroplasty due to the risk of postoperative chordee formation. 3 Substitution urethroplasty is ideal for the management of long anterior urethral strictures. The ideal material for substitution urethroplasty remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Traditionally, grafts have been placed on the ventral aspect of the urethra because it allows easier access to the urethra and a better visualization of the stricture. Some authors have espoused that use of oral mucosa grafts as ventral onlay grafts and gives good outcomes (Gupta et al, 2004;MacLaughlin et al, 2006) Barbagli et al ( 2003a) championed dorsal placement of the buccal mucosa grafts adducing that the dorsal approach to strictures of the bulbar urethra to be anatomically superior to ventral, requiring less extensive opening of the spongy tissue and reducing significant bleeding from the corpus spongiosum and mechanical weakening of the graft with better outcome. Dorsal placement of the graft on the urethra is simpler and safer in the distal part of the bulbar urethra whereas ventral placement of the graft is more efficacious in the proximal part of the bulbar urethra, where the spongiosum tissue is thicker and has better vascularise.…”

Section: Onlay Graft Orientationmentioning

confidence: 99%

Oral Mucosa Graft

Mungadi¹,

Agwu²

2011

Skin Grafts - Indications, Applications and Current Research

View full text Add to dashboard Cite

Dorsal Buccal Mucosal Graft Urethroplasty by a Ventral Sagittal Urethrotomy and Minimal-Access Perineal Approach for Anterior Urethral Stricture

Cited by 17 publications

References 0 publications

Outcome of Dorsal Onlay Buccal Mucosa Substitution Urethroplasty in Long Strictures of Anterior Urethra

Outcome of Dorsal Onlay Buccal Mucosa Substitution Urethroplasty in Long Strictures of Anterior Urethra

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

Oral Mucosa Graft

Contact Info

Product

Resources

About