Efficacy of Single Stage Dorsal Onlay Buccal Mucosal Graft Urethroplasty - 16 Years Long Term Outcome

Shivashankarappa Mudegoudar, Umesh K, Imdad Ali

Abstract


Introduction: Many surgical procedures have been described in literature for the management of pan urethral stricture, dorsal onlay BMG is one of them. Buccal mucosal graft is the most popular substitute used in the urethral reconstruction because of less technique difficulties. But placement of graft in ventral or dorsal or lateral position is still controversial. Doral placement of graft has its own advantages, vascularized bed; graft will be in stable position and prevention of pseudo-diverticulum formation.

 

Material and Methods: We present our more than 09 years (maximum 16 years) of long term result of 53 patients who underwent dorsal onlay BMG single stage technique from 2003 – 2009 as a prospective study. The success was defined as lack of obstructive symptoms, Qmax more than 15ml, PVR below 50ml and with or without requirement of single VIU.

 

Results: 53 patients had mean age of 42 years, with lichen sclerosis as predominate cause of stricture. The success rate was 77.4% (41/53) after 1, 3, 6 months and at 1 year follow up (see Table 3). The success rate in less than 50 years and more than 50 years was 33/42 (78.5%) and 8/11 (72.7%), respectively (P=0.27). The overall success rate is 80.48% after 9 year follow up.

 

Conclusion: Dorsal onlay Buccal mucosa urethroplasty single stage technique proves to be a satisfactory, valid graft to treat long segment anterior urethral strictures. Buccal graft harvesting is a simple and easy procedure.


Keywords


Dorsal onlay buccal mucosal graft, Urethral stricture, Urethroplasty, Mucosal Graft, Surgery, Pan urethral stricture.

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