Send to

Choose Destination
Urology. 2015 Apr;85(4):942-7. doi: 10.1016/j.urology.2015.01.013.

Two-sided dorsal plus ventral oral graft bulbar urethroplasty: long-term results and predictive factors.

Author information

Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy. Electronic address:
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
Department of Obstetrics, Gynecology and Urology, 'Sapienza' University, Rome, Italy.
Department of Urology, Clinica Cellini, Humanitas Institute, Torino, Italy.
Centro Chirurgico Toscano, Arezzo, Italy.
Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University, Rome, Italy.



To evaluate long-term outcomes of the 2-sided dorsal plus ventral oral graft (DVOG) urethroplasty by preserving the narrow urethral plate in tight bulbar strictures and investigate which factors might influence long-term outcomes.


This is a single-center retrospective study of 166 patients who underwent DVOG urethroplasty for tight bulbar strictures by a single surgeon (E.P.) between 2002 and 2013. The strictured urethra was opened ventrally; the exposed urethral plate was incised in the midline and augmented dorsally and ventrally using 2 oral grafts. Outcome was considered a failure when any postoperative instrumentation was needed. According to stricture length, patients were classified in 3 groups as follows: ≤1.5 cm (group 1), >1.5 and ≤3.9 cm (group 2), and ≥4 cm (group 3). Time to failure was analyzed using Kaplan-Meier estimates and Cox regression.


Median follow-up was 47 months (interquartile range, 33-95.5 months). Of the 166 patients, 149 (89.8%) were successful and 17 (10.2%) were failures. Most of the failures (90%) were observed during the first 5 years of follow-up; afterward, the success rate remained stable. The stricture length was a significant predictor of surgical outcome (odds ratio, 1.743 per cm; confidence interval, 1.2-2.5; P <.001); patients with a urethral stricture ≥4 cm presented a higher risk of late failure. Age, stricture etiology, and previous treatment were not significant predictors of surgical outcome.


With long-term follow-up, the treatment of tight bulbar strictures using a 2-sided DVOG urethroplasty showed a high success rate. The stricture length is an independent predictor of failure.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center