Dorsal onlay buccal mucosal graft urethroplasty in the treatment of urethral strictures - does the stricture length affect success?

Adv Clin Exp Med. 2015 Mar-Apr;24(2):297-300. doi: 10.17219/acem/40469.

Abstract

Background: Treatment of urethral strictures can be challenging, but, with appropriate preoperative evaluation and surgical planning it is possible to achieve successful results.

Objectives: To analyze if the stricture length affects the success with dorsal onlay buccal mucosal graft urethroplasty technique.

Material and methods: Between January 2004 and June 2010 a total of 40 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤7 cm, and >7 cm), and localization of the stricture were assessed as the factors affecting success rate.

Results: The clinical outcome was defined as a failure when any operative instrumentation including dilatation was needed or the urine flow rate was less than 14 mL per second at the sixth month, postoperatively. The mean follow-up period was 43.44 months. Of 40 patients, 28 (70%) were successful and 12 (30%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p=0.26 and p=0.41). The statistical difference was significant for the localization and length of the stricture by means of success (p=0.002 and p=0.025).

Conclusions: Our results show that the stricture length and localization are the most important variables for desirable success. Even though surgical techniques are constantly evolving, long strictures stay as a problem for urologists. Studies with larger number of patients with long urethral strictures may support our findings, and may prove the efficiency of these surgical techniques.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Mucosa / transplantation*
  • Patient Selection
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Recovery of Function
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Urethral Stricture / diagnosis
  • Urethral Stricture / physiopathology
  • Urethral Stricture / surgery*
  • Urodynamics
  • Urologic Surgical Procedures / adverse effects
  • Urologic Surgical Procedures / methods*
  • Young Adult