Double-face augmentation urethroplasty for bulbar urethral strictures: Analysis of short-term outcomes

Enganti, Bhavatej; Mannem, Srinath Reddy; Chiruvella, Mallikarjuna; Bendigeri, Mohammed Taif; Ragoori, Deepak; Ghouse, Syed Mohammed; Reddy, Purnachandra

doi:10.5152/tud.2020.20106

Cited by 5 publications

(6 citation statements)

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“…Buccal mucosa graft is actively used for reconstructive urethral surgery ( 17 ). The buccal mucosa is readily available for harvesting, less prone to immune reactions, and tolerates urinary tract pathogens.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture

et al. 2023

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Introduction: There is lack of papers dedicated to the laparoscopic buccal mucosa graft (BMG) ureteroplasty of the complex upper ureteral stricture. The aim of this study is to evaluate the results of laparoscopic BMG ureteroplasty in patients with complex proximal ureteral stricture. Material and methods: Twenty-four patients underwent laparoscopic ventral onlay BMG ureteroplasty for long or recurrent proximal ureteral stricture not amenable to uretero-ureteral anastomosis over 2019-2022. Patient demographics, operative time, estimated blood loss, length of stay, follow-up, intra- and postoperative complication rate and percentage of stricture-free at last visit were analyzed. Results: The mean stricture length was 3.6 cm. The mean operative time was 208.3 min, while mean blood loss was 75.8 mL. The length of hospital stay was 7.3 days. No intraoperative complications were observed. Postoperatively, seven patients developed complications (29.2%). Five patients experienced a Grade II (according to Clavien nomenclature). Two patients developed a Grade IIIa complication, which included leakage of the anastomosis site. The mean follow-up was on the 22 months with stricture free rate 87.5%. Conclusion: Patients with proximal ureteral strictures could be effectively treated by laparoscopic ventral onlay ureteroplasty with a buccal mucosa graft.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture

et al. 2023

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“…В метаанализ были включены 16 научных работ [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] c общим числом пациентов 1476 (см. таблицу).…”

Section: результатыunclassified

“…В другой работе при анализе данных пациентов со стриктурами протяженностью >2 см ЭД была выявлена у 16,2 % пациентов в послеоперационном периоде через 3 мес наблюдения и сохранилась у 5,4 % на 12-й месяц наблюдения [12].…”

Section: оригинальная статья / Original Reportunclassified

Erectile function evaluation in patients after urethroplasty: systematic review and meta-analysis

Chinenov

Shpot

Ismailov

et al. 2023

Androl. genit. hir.

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Background. The success of surgical treatment of urethral strictures is often assessed in terms of the quality of urination and the patency of the urethral lumen. Despite the fact that this assessment is carried out according to the above parameters, it seems important to take into account such a possible complication as erectile dysfunction, which can significantly impair the patient’s quality of life. This is the difference in the perception of the success of the surgical intervention by the clinician and the patient.Aim. To determine the relationship between urethroplasty and the likelihood of erectile dysfunction in the postoperative period according to world literature.Materials and methods. The PubMed database was analyzed using the keywords: anterior urethroplasty, posterior urethroplasty, urethroplasty, sexual dysfunction, erectile dysfunction. All articles were reviewed by two independent authors for inclusion based on predetermined criteria. Among the included scientific papers are randomized controlled trials, systematic reviews.Results. Sixteen scientific papers with a total of 1476 patients were included in the final study. The decrease in erectile function after surgery in this meta-analysis is 3 %. The main factors influencing postoperative parameters were age and erectile function at the time of surgery.Conclusion. Most studies state that urethroplasty does not imply a significant impact on erectile function, however, they acknowledge that the occurrence of this complication affects the assessment of treatment outcomes among patients and the further impact on their quality of life, regardless of postoperative urinary function.

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“…A ventral approach for DFAU was considered for patients in whom the distal end of the BUS was proximal to the bulbospongiosus muscle (and extended into the proximal bulbar urethra) [6] . The ventral approach was also considered when the width of the corpus spongiosum (measured using calipers) was >15 mm [9] . Ventral sagittal urethrotomy was performed and the urethral stricture was opened until the normal urethral lumen was identified.…”

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confidence: 99%

“…A ventral approach is safe only for strictures involving the proximal two-thirds of the bulbar urethra [1] , [5] . For these strictures, the width of the corpus spongiosum is important (width >15 mm is normally safe for a ventral approach [9] ). However, a dorsal DFAU approach is safe and can be considered for all BUS cases [1] .…”

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confidence: 99%

Double-face Augmentation Urethroplasty for Bulbar Urethral Strictures: Technical Implications and Short-term Outcomes for a Dorsal Versus Ventral Approach

Enganti

Chiruvella

Bendigeri

et al. 2021

European Urology Open Science

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This study describes technical implications and compares short-term outcomes after a dorsal versus ventral approach for double-face augmentation urethroplasty (DFAU) for treating a near-obliterated bulbar urethral stricture (BUS). This was a retrospective evaluation of a prospectively collected database of patients with BUS (<2 cm) who underwent DFAU. The choice between the approaches depended on (1) landmark identification (the relation between the bulbospongiosus muscle and the distal end of the stricture) and (2) corpus spongiosum width. In DFAU, inlay augmentation was at the level of the narrowed urethral plate (<6 Fr). Patient follow-up data (symptom score and uroflowmetry) were assessed every 3 mo for the first year, and every 6 mo thereafter. A successful outcome was defined as a normal urinary flow rate without obstructive voiding symptoms. Fifty-two patients underwent DFAU for BUS (dorsal approach, n = 30; ventral approach, n = 22). The maximum flow rate and symptom scores significantly improved in both groups. The overall success rates (86%) were similar. In conclusion, a dorsal approach for DFAU is versatile and can be considered in all circumstances. A ventral approach should be performed in patients with proximal BUS. The short-term outcomes were similar for both approaches. Patient summary We assessed whether double-face augmentation urethroplasty is a suitable option for treating near-obliterated bulbar urethral strictures using two free grafts for augmentation to improve the urinary flow. This operation can be performed using two methods and both techniques were safe with similar short-term outcomes.

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Double-face augmentation urethroplasty for bulbar urethral strictures: Analysis of short-term outcomes

Abstract: Ali Serdar Gözen, et al.; Robot-assisted vasovasostomy and vasoepididymostomy: Current status and review of the literature.

Cited by 5 publications

References 12 publications

Laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture

Laparoscopic ventral onlay ureteroplasty with buccal mucosa graft for complex proximal ureteral stricture

Erectile function evaluation in patients after urethroplasty: systematic review and meta-analysis

Double-face Augmentation Urethroplasty for Bulbar Urethral Strictures: Technical Implications and Short-term Outcomes for a Dorsal Versus Ventral Approach

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