Repair of panurethral stricture: Proximal ventral and distal dorsal onlay technique of buccal mucosal graft urethroplasty

Abstract

ObjectiveTo report the surgical details and results of our technique of buccal mucosal graft (BMG) urethroplasty for panurethral stricture, as many studies have reported repair of panurethral stricture by single-stage BMG urethroplasty by placing buccal mucosa ventrally, dorsally or dorsolaterally.Patients and methodsThis was an observational analysis of 38 patients with panurethral stricture treated by placing two BMGs, one as a ventral onlay in the proximal bulbar urethra and the other as a dorsal onlay in the distal bulbar and penile urethra. Success was defined as asymptomatic state with or without need for a postoperative single intervention such as dilatation or internal urethrotomy.ResultsThe 38 patients had a mean age of 44 years, with lichen sclerosus as the predominant cause of stricture. The ultimate success rate was 84.2% at the end of 3 months and 89.5% at the end of 1 year. Recurrent strictures appeared only in the failed cases during the follow-up period of 11 months. None of the patients needed redo urethroplasty during the follow-up period.ConclusionsA proximal ventral and distal dorsal onlay technique of BMG urethroplasty is an available alternative for repairing panurethral stricture. The technique described is simple and easily reproducible with encouraging results compared to other similar techniques.

One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus-Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-Analysis

“…Chodisetti et al also used combination ventral and dorsal grafts in LS patients, but exclusively used the ventral graft in the bulbar urethra where the ventral spongiosum is more robust than in the penile urethra. 20 The authors reported a 19% recurrence rate among patients with LS using this technique. Lastly, Kunz et al 25 and Al-Hakeem et al 14 describe performing mostly ventral graft urethroplasties; however, it is not clear if this technique was utilized for their subset of patients with LS as well.…”

“…A total of 21 studies were identified for inclusion in the review. 5,6,14–32 Figure 1 shows a detailed PRISMA flowchart of the selection process.…”