Title: Buccal Mucosal Graft Urethroplasty: Our Centre Experience
Authors: Dr Arvind Kumar Prabhat, Dr Mallipeddi Partha Sri, Dr P Bala Murali Krishna, Dr Dammalpati Mahesh Rahul, Dr Kapang Yirang, Dr U Surya Kumari
DOI: https://dx.doi.org/10.18535/jmscr/v10i9.03
Abstract
Introduction: Urethral stricture affects 300 per one lakh males and its treatment challenges the surgeons. Surgical treatment includes urethral dilatation, Visual internal urethrotomy and anastomotic or flaps/grafts based augmentation urethroplasty.
Aims and Objectives: Outcomes of buccal mucosal graft urethroplasty in males with long segment anterior urethral stricture.
Materials and Methods: A retrospective study at Dr PSIMS & RF, Vijayawada, Andhra Pradesh between January 2017 and December 2020. During this time period 38 male patients undergone dorsal onlay buccal mucosal graft urethroplasty.
Results: The mean (range) age of 38 male patients was 41 (25 - 72) years. The mean (range) urethral stricture length was 8 cm (5 - 12 cm). Etiology in 18 (47.37%) patients were lichen sclerosus (LS) and in 20 (52.63%) patients were non lichen sclerosus(NLS). Previous history of urethral dilatation in 11(28.95%) cases, visual internal urethrotomy (VIU) in 9 (23.68%%) cases, pelvic trauma in 6(15.79%) cases and transurethral resection of prostate(TURP) in 4(10.53%) cases. Preoperative diagnosis made by uroflowmetry(UFR) and retrograde urethrogram(RGU). Stricture sites were penile, bulbar, penobulbar and pananterior in 9(23.68%), 10(26.32%), 5(13.16%) and 14(36.84%) patients respectively. Suprapubic catheterization (SPC) was done one month prior to definitive surgery in all cases. Delayed complications as erectile dysfunction and short segment stricture in 8(21.05%) and 4(10.53%) patients respectively. VIU was done in these short segment stricture 4(%) patients. Follow-up in all patients at one month by urethrocystoscopy, uroflowmetry(UFR) at 3rd month, retrograde urethrogram(RGU) at one year and UFR at every six months. Outcomes measured by flow rate Qmax > 15 ml/s and urethral caliberation by Nelaton 14 Fr catheter.
Conclusion: Dorsal onlay buccal mucosal graft urethroplasty improves quality of life(QOL) in mens with long segment anterior urethral stricture and gives patients satisfaction interms of urinary continance and sexual function.
Keywords: Retrograde urethrogram (RGU), Uroflowmetry (UFR), Buccal mucosal graft (BMG).
