Dorsal onlay (Barbagli technique) versus dorsal inlay (Asopa technique) buccal mucosal graft urethroplasty for anterior urethral stricture: A prospective randomized study

Abstract

Objective: To compare both the dorsal onlay technique of Barbagli and the dorsal inlay technique of Asopa for the management of long anterior urethral stricture. Methods: From January 2010 to May 2012, a total of 47 patients with long anterior urethral strictures were randomized into two groups. The first group included 25 patients who were managed by dorsal onlay buccal mucosal graft urethroplasty. The second group included 22 patients who were managed by dorsal inlay buccal mucosal graft urethroplasty. Different clinical parameters, postoperative complications and success rates were compared between both groups. Results: The overall success rate in the dorsal onlay group was 88%, whereas in the dorsal inlay group the success rate was 86.4% during the follow-up period. The mean operative time was significantly longer in the dorsal onlay urethroplasty group (205 ± 19.63 min) than in the dorsal inlay urethroplasty group (128 ± 4.9 min, P-value <0.0001). The average blood loss was significantly higher in the dorsal onlay urethroplasty group (228 ± 5.32 mL) than in the dorsal inlay urethroplasty group (105 ± 12.05 mL, P-value <0.0001). Conclusions:The dorsal onlay technique of Barbagli and the dorsal inlay technique of Asopa buccal mucosal graft urethroplasty provide similar success rates. The Asopa technique is easy to carry out, provides shorter operative time and less blood loss, and it is associated with fewer complications for anterior urethral stricture repair.Key words: anterior uretheral sricture, buccal mucosal graft, dorsal inlay technique of Asopa, dorsal onlay technique of Barbagli.

Redo buccal mucosa graft urethroplasty: success rate, oral morbidity and functional outcomes

“…The harvest site was routinely (4.0 monofilament interrupted sutures) closed. One‐stage bulbar redo BMGU was performed using the ventral‐onlay technique for bulbar and the dorsal inlay technique for penile recurrent strictures, as described previously for initial BMGU . A transurethral and a suprapubic catheter were placed intra‐operatively.…”

Ten Years' Experience for Hypospadias Repair: Combined Buccal Mucosa Graft and Local Flap for Urethral Reconstruction

“…Aldaqadossi et al [13] also reported that dorsal onlay and dorsal inlay urethroplasties provide similar success rates, but the onlay technique is harder to perform, has a longer operative time and more blood loss and is associated with more complications. Second, while the urethra is widened, more covering tissue is required, and sometimes we need to transfer scrotal tissue to cover the wounds of the ventral side.…”

One-stage dorsal inlay oral mucosa graft urethroplasty for anterior urethral stricture

“…The approach also requires less extensive exposure of the spongy tissue, less bleeding from the corpus spongiosum, and less mechanical damage to the graft [20-22]. The dorsal onlay technique of Barbagli and the dorsal inlay technique of Asopa buccal mucosal graft urethroplasty provide similar success rates, but the Asopa technique is easy to carry out, provides shorter operative time and less blood loss, and it is associated with fewer complications for anterior urethral stricture repair [23]. …”