Post-Surgical Outcomes of Dorsolateral Onlay Urethroplasty

Abstract

Background: The standard management of urethral strictures involving the anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischemia of the urethra in addition to chordee. In this research, we managed the anterior urethral stricture, applying a dorsolateral onlay urethroplasty.Methodology: This prospective study was conducted in the Department of Urology, BIRDEM General Hospital& some private hospitals from July 2009 to June 2015, the outcomes of a total cases of 103 of one sided anterior dorsolateral onlay OMG Urethroplastywere assess and compared. Patients with anterior and recurrent urethral stricture more than 1 cm were included as study population. Urethrogram and Uroflowmetry were the mainstay of assessment. Success was defined as a maximum flow rate of>20 ml/sec., normal RGU, and/or urethroscopy. Poor outcomes were defined as the presence of obstructive urinary tract symptoms, Qmax <15 ml/sec., stricture diagnosed on retrograde urethrogram/ urethroscopy, and the need for any postoperative urethral intervention.Result: Of the 103 patients, 97 had (94.2%) successful outcome and 6 (5.8%) were failure. Four failed cases underwent optical internal urethrotomy and two patients had persistent narrowing and they were managed by BMG Urethroplasty. Follow up period was 12 months on an average. In conclusion, it can be said thatthe preservation of one sided vascular supply to the urethra and its entire muscular and neurogenic support represent significantly towards perfecting the surgical technique of urethral reconstruction using a minimally invasive approach.Conclusion: In this study, we found it to be a technically feasible, easily adoptable and finally successful procedure.Anwer Khan Modern Medical College Journal Vol. 7, No. 2: Jul 2016, P 16-19

Substitution Buccal Mucosal Graft Urethroplasty for Long Segment Anterior Urethral Stricture : Our Experience in Dorsolateral Onlay Approach

“…Kulkarni et al shows in the study of 24 patients with mean follow up of 22 months, 92% successful outcome where 02 (8%) were failed 13 . In our study, mean pre and postoperative Qmax were 6.75 ml/s and 23.47 ml/s whereas Prabha et al and Mowladad et al showed 6.5 ml/s and 24 ml/s, 6.08 ml/s and 29.04 ml/s respectively in their studys 12,14 . Prabha et al, Tapas Majhi, Prakasa et al, reported that most common complication was wound infection (10%, 10%, 11.4%) which is also similar to us (9.4%) 4,12,15 .…”

“…Regarding postoperative patients compliance, 28 patients (87.5%) were satisfied with surgery upto 22.4 months mean follow up. In their study, they were reported 94%, 85%, 96%, 76% and 94.2% success rate respectively through this approach with a mean follow up of 19, 22.7, 18, 18 and 12 months 11,12,14,15 . Kulkarni et al shows in the study of 24 patients with mean follow up of 22 months, 92% successful outcome where 02 (8%) were failed 13 .…”