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Urology. 2013 Apr;81(4):899-902. doi: 10.1016/j.urology.2012.11.055. Epub 2013 Mar 7.

Combining ventral buccal mucosal graft onlay and dorsal full thickness skin graft inlay decreases failure rates in long bulbar strictures (≥6 cm).

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1
Detroit Medical Center, Michigan State University College of Osteopathic Medicine, Detroit, MI 48201, USA.

Abstract

OBJECTIVE:

To evaluate the efficacy of augmenting ventral onlay buccal urethroplasty using a using a double-sided graft technique by adding a second, full-thickness skin graft (FTSG) dorsally in long strictures ≥4 cm, we hypothesized that a double-sided graft technique would improve surgical outcomes over buccal mucosal graft (BMG) ventral onlay urethroplasty alone.

METHODS:

Retrospective chart review was performed comparing 15 patients who had undergone double-sided BMG + FTSG urethroplasty for long strictures ≥4 cm to a cohort group of 115 patients who had undergone BMG onlay urethroplasty for strictures of similar length. Comparisons of age, stricture lengths, time-to-failure, follow-up intervals, and failure rates were analyzed. Further analysis included age and stricture length matched control comparisons between BMG + FTSG patients to BMG only patients.

RESULTS:

Mean patient age, stricture length, and time to stricture recurrence were 44 years, 5.1 cm, and 10 months, respectively, in the BMG group. For the BMG + FTSG group, mean age was 52 years, stricture length 5.9 cm, and time to recurrence was 9 months. Overall, the BMG group had a decreased failure rate; 17% compared to 21%. Further analysis showed BMG ventral onlay had decreased failure rates for strictures <6 cm; 16% compared to 33%. However, for strictures ≥6 cm, the BMG + FTSG had a 0% failure rate compared to 24% in the BMG ventral onlay group (P = .005).

CONCLUSION:

Combined BMG and FTSG urethroplasty for very long bulbar urethral strictures ≥6 cm improve success rates compared to using BMG urethroplasty alone.

Comment in

PMID:
23465157
DOI:
10.1016/j.urology.2012.11.055
[Indexed for MEDLINE]

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