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Urology. 2003 May;61(5):1004-7.

Ventral onlay urethroplasty using buccal mucosa for complex stricture repair.

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Department of Urology, Julius-Maximilians University Medical School, W├╝rzburg, Germany.



To report the short to medium-term results of one-stage buccal mucosa ventral onlay in the treatment of recurrent urethral stricture disease.


Between April 1997 and July 2001, buccal mucosa was used as a ventral onlay graft in 38 patients with recurrent strictures of the bulbar (n = 30) and proximal penile urethra (n = 8). All patients had undergone at least 1 urethrotomy (range 1 to 10; mean 2.9) before reconstruction. Prospective follow-up included a simple questionnaire on patient satisfaction, uroflowmetry, and ultrasound estimation of postvoid residual urine volume and, in the case of recurrence, retrograde urethrography and cystoscopy.


The primary success rate at a mean follow-up of 22.8 months (range 8.7 to 40.7) was 80%. Stricture recurred in 7 patients, mostly within 12 months. A distinct residual irregularity at the former stricture site in the initial postoperative urethrogram was predictive of failed reconstruction. A second procedure was performed in 4 patients (1 urethrotomy and 3 re-buccal mucosa onlay grafts) with good results. Patient satisfaction was high in most instances. Three patients refused reoperation, preferring regular intermittent dilation.


When end-to-end anastomosis is impossible, onlay urethroplasty using buccal mucosa is a rather simple alternative with encouraging short to medium-term results in the proximal segments of the male urethra.

[Indexed for MEDLINE]

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