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Outcome of dorsal buccal graft urethroplasty for recurrent bulbar urethral strictures
Author(s) -
O’Riordan Anna,
Narahari Radnakrishna,
Kumar Vinod,
Pickard Robert
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.07763.x
Subject(s) - urethroplasty , medicine , surgery , urethral stricture , urethrotomy , buccal administration , complication , prospective cohort study , urethra , dentistry
OBJECTIVE To audit our results of dorsal buccal mucosal graft urethroplasty for recurrent bulbar urethral stricture disease and compare them with those from specialist centres. PATIENTS AND METHODS Data were collected prospectively on 52 men who had urethroplasty with ≥1 year of follow‐up; failure was defined as the need for further intervention. RESULTS The mean (range) age of the patients was 39 (19–61) years and 23 (45%) had an identifiable cause for their stricture. The mean (range) stricture length was 3.5 (1.5–6) cm and was associated with moderate or severe spongiofibrosis in 38 (73%) men. Ten (19%) men had minor complications after surgery. The mean (range) follow‐up was 34 (12–80) months, with the mean maximum urinary flow rate increasing from 6 to 24 mL/s after surgery. The surgery failed, requiring dilatation or urethrotomy, in seven (14%) men at a mean (range) of 25 (15–50) months after urethroplasty, giving an overall success rate of 86%. CONCLUSION This prospective audit of dorsal buccal patch augmentation urethroplasty for bulbar strictures shows an equivalent outcome to the standard set by the expert originators, suggesting that is transferable to less specialized centres. The efficacy, low complication rate, short hospital stay and general applicability of the technique encourage its use for all men with recurrent bulbar stricture disease, but formal comparison with other options in randomized trials, including cost‐effectiveness analysis, is needed.