Use of buccal mucosa as onlay graft technique for benign ureteric strictures

Objectives: To cure long and multiple ureteric strictures by a simple procedure without the long term complications of bowel interposition or surgery of high magnitude like auto-transplantation. Methods: Ureteric strictures in 5 patients were treated with buccal mucosa onlay grafts with an omental wrap. The underlying etiology was tuberculosis in 4 patients and amyloidosis in I patient. Mean age was 45 years. Three patients had strictures in upper ureter, 1 patient in mid­ureter and 1 patient had panureteric stricture. In all pa­tients length of stricture was greater than 5 cm. Results: Ureteric patency was established in all patients. Four patients have persistent improvement in renal func­tion. In I patient, renal function improved initially (at 6 months follow-up) but subsequently (at 1-year follow-up) the unit was non functioning. Follow-up was in the range of 1.5 year to 3.5 years. Conclusions: In selected patients with complicated be­nign ureteric strictures, buccal mucosal dorsal onlay graft was proved capable of maintaining patency and good uri­nary drainage. The procedure is technically simple and devoid of complications.