The use of a buccal graft for urethroplasty of urethral strictures in men
N.V. PolyakovН Г КешишевA.D. TrofimchukI.A. AbdulaevA.V. KazachenkoИ. В. ЧернышевС. П. ДаренковО.И. Аполихин
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Introduction. The urethroplasty of the urethral stricture disease is still a severe problem for surgeons. The aim of this study is to evaluate own results of buccal mucosa graft urethroplasty (BMGU) for the treatment of urethral stricture. Aim. Evaluation of own results of urethroplasty with a graft of the oral mucosa in the treatment of urethral strictures. Materials and methods. Between 01.08.2014 and 01.06.2020 we treated 136 patients with urethral stricture at our Medical Centers, where we provided buccal mucosa graft urethroplasty for bulbar and penile urethra. Results. The bulbar stricture was found among 105 patients of 136 (77,1 % cases), in which 64 had stricture in proximal part and 41 – in distal part of the urethra, 19 patients – in penile urethra and the other part had panurethral lesion. The median length of the stricture was measured as 3,8 ± 0,6 sm in the first three groups, and in the last group it was 10,4 ± 1,5 sm. At a median follow-up of 16,3 months 87,5% of patients in the first group, 90,2 % in the second, 84,2 % in the third and 83,3 % in the fourth group had no stricture recurrence and were satisfied with BMGU. Conclusion. For patients with urethral stricture disease, BMGU offers excellent success, morbidity with different techniques and methods, which statistically are equal to each other.Keywords:
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No AccessJournal of Urology1 Nov 1992Urethral Stricture in Children: Treatment by Urethroplasty with Bladder Mucosa Graft G. Monfort, D. Bretheau, V. Di Benedetto, and R. Bankole G. MonfortG. Monfort More articles by this author , D. BretheauD. Bretheau More articles by this author , V. Di BenedettoV. Di Benedetto More articles by this author , and R. BankoleR. Bankole More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)36950-1AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Urethral strictures in children, which are not frequent, often require urethroplasty when dilations and/or urethrotomies have failed. A bladder mucosa graft was used successfully for urethral reconstruction to treat posterior hypospadias. We describe our experience with a bladder mucosa graft during urethroplasty for acquired urethral strictures in 8 children. Urethral strictures secondary to the treatment of hypospadias were excluded. Bladder mucosa was used successfully as an onlay or patch graft urethroplasty in 7 patients. One patient had a tubularized graft with secondary stenosis treated successfully by dilation. © 1992 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByEL-SHERBINY M, ABOL-ENEIN H, DAWABA M and GHONEIM M (2018) Treatment of Urethral Defects: Skin, Buccal or Bladder Mucosa, Tube or Patch? An Experimental Study in DogsJournal of Urology, VOL. 167, NO. 5, (2225-2228), Online publication date: 1-May-2002.PANSADORO V, EMILIOZZI P, GAFFI M and SCARPONE P (2018) BUCCAL MUCOSA URETHROPLASTY FOR THE TREATMENT OF BULBAR URETHRAL STRICTURESJournal of Urology, VOL. 161, NO. 5, (1501-1503), Online publication date: 1-May-1999.LEVINE L and ELTERMAN L (2018) URETHROPLASTY FOLLOWING TOTAL PHALLIC RECONSTRUCTIONJournal of Urology, VOL. 160, NO. 2, (378-382), Online publication date: 1-Aug-1998. Volume 148Issue 5 Part 1November 1992Page: 1504-1506 Advertisement Copyright & Permissions© 1992 by The American Urological Association Education and Research, Inc.Keywordsurethral stricturepediatricsMetricsAuthor Information G. Monfort More articles by this author D. Bretheau More articles by this author V. Di Benedetto More articles by this author R. Bankole More articles by this author Expand All Advertisement Loading ...
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Male urethral stricture is scarring of the urethral tissue that narrows the urethral lumen causing reduced urinary flow. Urethral reconstruction or substitution urethroplasty using oral mucosa graft, especially from the buccal mucosa, is one of the most widely known techniques to manage urethral stricture. However, studies using bilateral buccal mucosa are still limited. Therefore, this study aims to report our experience and technique of bilateral buccal mucosa grafting for urethroplasty. The authors described a 66-year-old man with long-segment urethral stricture that was successfully treated with urethral reconstruction harvested from bilateral buccal mucosa.
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Urethral strictures are difficult to manage. Some treatment modalities for urethral strictures are fraught with high patient morbidity and stricture recurrence rates; however, an extremely useful tool in the armamentarium of the Reconstructive Urologist is buccal mucosal urethroplasty. We like buccal mucosa grafts because of its excellent short and long-term results, low post-operative complication rate, and relative ease of use. We utilize it for most our bulbar urethral stricture repairs and some pendulous urethral stricture repairs, usually in conjunction with a first-stage Johanson repair. In this report, we discuss multiple surgical techniques for repair of urethral stricture disease. Diagnosis, evaluation of candidacy, surgical techniques, post-operative care, and complications are included. The goal is to raise awareness of buccal mucosa grafting for the management urethral stricture disease.
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Objective To evaluate the early results of anterior urethroplasty using a one‐stage free graft with buccal mucosa. Patients and method Thirty‐nine patients (aged 23–59 years) underwent a one‐stage urethroplasty using buccal mucosa, 28 as a patch and 11 as tube grafts. All patients were evaluated by post‐operative urethrography at 6 months and were followed using urinary flow rates and symptoms for 2–5 years. Result There was one recurrent stricture (3%) in the group with a patch urethroplasty but five of the 11 patients with tube grafts had a recurrent stricture. Conclusion The early results using buccal mucosa for patch urethroplasty are encouraging. Although the results from tube grafts are poor, they are similar to those from other methods of single‐stage urethroplasty.
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No AccessJournal of UrologyClinical Urology: Original Article1 Jun 1996Use of Free Grafts in Urethral Stricture Reconstruction Hunter Wessells and Jack W. McAninch Hunter WessellsHunter Wessells and Jack W. McAninchJack W. McAninch View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66045-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The indications, contraindications and results of free graft urethroplasty are determined. Materials and Methods: A retrospective review was done of 40 consecutive patients who underwent free graft urethroplasty with penile and preputial skin, buccal mucosa and bladder epithelium. Results: Of the 35 patients in whom adequate followup data were available the outcome was successful in 30 (86 percent). Success was unrelated to donor site, prior intervention or cause of stricture. Failure was attributed to placement of grafts onto the penile urethra and patient age. Conclusions: For strictures in the bulbar urethra the success rate of free grafts was high. Failures occurred in patients in whom full thickness skin grafts were extended far onto the penile urethra. References 1 : Use of full thickness skin grafts in repair of urethral strictures. J. Urol.1963; 90: 67. Link, Google Scholar 2 : The use of buccal mucosa patch graft in the management of anterior urethral strictures. J. Urol.1993; 149: 276. Link, Google Scholar 3 : Urethral stricture in children: treatment by urethroplasty with bladder mucosa graft. J. Urol.1992; 148: 1504. Google Scholar 4 : The buccal mucosal graft for urethral reconstruction: a preliminary report. J. Urol.1992; 147: 662. Link, Google Scholar 5 : Reconstruction of extensive urethral strictures: circular fasciocutaneous penile flap. J. Urol.1993; 149: 488. Link, Google Scholar 6 : Pedicled preputial patch urethroplasty. Brit. J. 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Google Scholar From the Department of Urology, University of California School of Medicine, and San Francisco General Hospital, San Francisco, California.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKurtzman J, Blum R and Brandes S (2021) One-Stage Buccal Mucosal Graft Urethroplasty for Lichen Sclerosus-Related Urethral Stricture Disease: A Systematic Review and Pooled Proportional Meta-AnalysisJournal of Urology, VOL. 206, NO. 4, (840-853), Online publication date: 1-Oct-2021.Barbagli G, Akbarov I, Heidenreich A, Zugor V, Olianas R, Aragona M, Romano G, Balsmeyer U, Fahlenkamp D, Rebmann U, Standhaft D and Lazzeri M (2018) Anterior Urethroplasty Using a New Tissue Engineered Oral Mucosa Graft: Surgical Techniques and OutcomesJournal of Urology, VOL. 200, NO. 2, (448-456), Online publication date: 1-Aug-2018.Ather M, Zehri A, Soomro K and Nazir I (2009) The Safety and Efficacy of Optical Urethrotomy Using a Spongiosum Block With Sedation: A Comparative Nonrandomized StudyJournal of Urology, VOL. 181, NO. 5, (2134-2138), Online publication date: 1-May-2009.El Kassaby A, AbouShwareb T and Atala A (2008) Randomized Comparative Study Between Buccal Mucosal and Acellular Bladder Matrix Grafts in Complex Anterior Urethral StricturesJournal of Urology, VOL. 179, NO. 4, (1432-1436), Online publication date: 1-Apr-2008.Dubey D, Vijjan V, Kapoor R, Srivastava A, Mandhani A, Kumar A and Ansari M (2007) Dorsal Onlay Buccal Mucosa Versus Penile Skin Flap Urethroplasty for Anterior Urethral Strictures: Results From a Randomized Prospective TrialJournal of Urology, VOL. 178, NO. 6, (2466-2469), Online publication date: 1-Dec-2007.Markiewicz M, Lukose M, Margarone J, Barbagli G, Miller K and Chuang S (2007) The Oral Mucosa Graft: A Systematic ReviewJournal of Urology, VOL. 178, NO. 2, (387-394), Online publication date: 1-Aug-2007.Abouassaly R and Angermeier K (2018) Augmented Anastomotic UrethroplastyJournal of Urology, VOL. 177, NO. 6, (2211-2216), Online publication date: 1-Jun-2007.Thompson J, Zmaj P, Cummings J and Steinhardt G (2018) An Approach for Using Full Thickness Skin Grafts for Complex Penile Surgeries in ChildrenJournal of Urology, VOL. 175, NO. 5, (1869-1871), Online publication date: 1-May-2006.EL-SHERBINY M, ABOL-ENEIN H, DAWABA M and GHONEIM M (2018) Treatment of Urethral Defects: Skin, Buccal or Bladder Mucosa, Tube or Patch? An Experimental Study in DogsJournal of Urology, VOL. 167, NO. 5, (2225-2228), Online publication date: 1-May-2002.KANE C, TARMAN G, SUMMERTON D, BUCHMANN C, WARD J, O’REILLY K, RUIZ H, THRASHER J, ZORN B, SMITH C and MOREY A (2018) MULTI-INSTITUTIONAL EXPERIENCE WITH BUCCAL MUCOSA ONLAY URETHROPLASTY FOR BULBAR URETHRAL RECONSTRUCTIONJournal of Urology, VOL. 167, NO. 3, (1314-1317), Online publication date: 1-Mar-2002.JOSEPH J, ANDRICH D, LEACH C and MUNDY A (2018) URETHROPLASTY FOR REFRACTORY ANTERIOR URETHRAL STRICTUREJournal of Urology, VOL. 167, NO. 1, (127-129), Online publication date: 1-Jan-2002.METRO M, WU H, SNYDER H, ZDERIC S and CANNING D (2018) BUCCAL MUCOSAL GRAFTS: LESSONS LEARNED FROM AN 8-YEAR EXPERIENCEJournal of Urology, VOL. 166, NO. 4, (1459-1461), Online publication date: 1-Oct-2001.BARBAGLI G, PALMINTERI E, LAZZERI M, GUAZZONI G and TURINI D (2018) LONG-TERM OUTCOME OF URETHROPLASTY AFTER FAILED URETHROTOMY VERSUS PRIMARY REPAIRJournal of Urology, VOL. 165, NO. 6 Part 1, (1918-1919), Online publication date: 1-Jun-2001.GURALNICK M and WEBSTER G (2018) THE AUGMENTED ANASTOMOTIC URETHROPLASTY: INDICATIONS AND OUTCOME IN 29 PATIENTSJournal of Urology, VOL. 165, NO. 5, (1496-1501), Online publication date: 1-May-2001.ANDRICH D and MUNDY A (2018) SUBSTITUTION URETHROPLASTY WITH BUCCAL MUCOSAL-FREE GRAFTSJournal of Urology, VOL. 165, NO. 4, (1131-1134), Online publication date: 1-Apr-2001.ANEMA J, MOREY A, MCANINCH J, MARIO L and WESSELLS H (2018) COMPLICATIONS RELATED TO THE HIGH LITHOTOMY POSITION DURING URETHRAL RECONSTRUCTIONJournal of Urology, VOL. 164, NO. 2, (360-363), Online publication date: 1-Aug-2000.LEVINE L and ELTERMAN L (2018) URETHROPLASTY FOLLOWING TOTAL PHALLIC RECONSTRUCTIONJournal of Urology, VOL. 160, NO. 2, (378-382), Online publication date: 1-Aug-1998.Barbagli G, Palminteri E, Bartoletti R, Selli C and Rizzo M (2018) LONG-TERM RESULTS OF ANTERIOR AND POSTERIOR URETHROPLASTY WITH ACTUARIAL EVALUATION OF THE SUCCESS RATESJournal of Urology, VOL. 158, NO. 4, (1380-1382), Online publication date: 1-Oct-1997.Wessells H, Morey A and McAninch J (2018) Single Stage Reconstruction of Complex Anterior Urethral Strictures: Combined Tissue Transfer TechniquesJournal of Urology, VOL. 157, NO. 4, (1271-1274), Online publication date: 1-Apr-1997.Wessells H (2018) Re: Dorsal Free Graft UrethroplastyJournal of Urology, VOL. 156, NO. 4, (1447-1447), Online publication date: 1-Oct-1996. Volume 155Issue 6June 1996Page: 1912-1915 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Hunter Wessells More articles by this author Jack W. McAninch More articles by this author Expand All Advertisement PDF downloadLoading ...
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Background: Urethral stricture is a chronic and common urological problem in Bangladesh and its management poses a big challenge to urologists. Surgical treatment of urethral stricture diseases is a continuously evolving process, and the superiority of one technique over another has yet to be clearly demonstrated. Urethrotomy is the most commonly used technique but long term results are not satisfactory. Long penile urethral strictures are best treated by substitution urethroplasty. The ideal graft material for substitution urethroplasty is constantly evolving. Buccal mucosa produces excellent result but is associated with many long term donor site complications. Lingual mucosa is an alternative donor site for graft urethroplasty and achieved good functional and aesthetic results. Materials & Methods: A hospital based prospective study was conducted in the department of urology, Dhaka Medical College Hospital from July 2016 to March 2017. Total 40 patients were included in this study. They were divided in two groups, group 1 was treated by lingual mucosal graft and group 2 was treated by buccal mucosal graft. All patients were followed up for six months noting pre and post-operative maximum urine flow rate (Qmax), voiding time and complications at both urethroplasty and donor site. Results: There were no significant differences in overall operative success rate between two groups of patients. But complications at donor site were higher in group 2 patients. Conclusion: Lingual mucosal graft urethroplasty may be preferred to buccal mucosa in anterior urethral stricture as it is easy to harvest and is associated with less short and long term donor site complications without significant difference in operative success rate. KYAMC Journal Vol. 13, No. 02, July 2022: 108-114
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You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II1 Apr 2017PD26-04 MEDIUM TERM OUTCOMES OF VENTRAL-ONLAY BUCCAL MUCOSA GRAFT SUBSTITUTION URETHROPLASTY FOR URETHRAL STRICTURE IN FEMALES Bashir Mukhtar, Marco Spilotros, Mahreen Pakzad, Rizwan Hamid, Jeremy Ockrim, and Tamsin Greenwell Bashir MukhtarBashir Mukhtar More articles by this author , Marco SpilotrosMarco Spilotros More articles by this author , Mahreen PakzadMahreen Pakzad More articles by this author , Rizwan HamidRizwan Hamid More articles by this author , Jeremy OckrimJeremy Ockrim More articles by this author , and Tamsin GreenwellTamsin Greenwell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1212AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Female urethral stricture causes significant morbidity. There is a high rate of recurrence following endoscopic management. Urethroplasty for female urethral stricture (FUS) is a rare but increasingly common procedure. We report our medium term outcomes for ventral-onlay buccal mucosa graft substitution urethroplasty (VOBMGSU) in treating FUS. METHODS From our prospectively acquired database we reviewed the outcomes of 22 consecutive women (median age 50 years, range 34-72) with FUS having VOBMGSU from June 2012 and with a minimum follow up of 6 months (median 21.5, range 6-51). Data was analysed for complications, stricture recurrence, change in median peak free flow rate (Qmax) and median post-void residuals (PVR). Statistical analysis was performed using the Wilcoxon signed rank test, Students TTest and Mann-Whitney U Test . RESULTS At last follow-up 21/22 (95%) of women were stricture free. Median Qmax was significantly improved from 7 ml/s (range 3.5-11.2) to 18 ml/s (range 5- 37) (p < 0.05). Median PVR was significantly reduced from 100mls (range 0-300) to 15 mls (range 0-150) (p < 0.05). Short and longer-term complication rates were low. 1 patient developed mild de novo stress urinary incontinence, which settled with conservative measures by 6 months. CONCLUSIONS Early and medium term results indicate that VOBMGSU is an excellent treatment for female urethral stricture that can avoid the need for the repeat procedures regularly required after traditional endoscopic management. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e507 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Bashir Mukhtar More articles by this author Marco Spilotros More articles by this author Mahreen Pakzad More articles by this author Rizwan Hamid More articles by this author Jeremy Ockrim More articles by this author Tamsin Greenwell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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Objective: To assess the outcome of one stage urethroplasty using buccal mucosa for long segment (>2cm) urethral stricture. Material & Method: This retrospective study was done in a private Hospital at Jessore from May, 2010 to October, 2012. Twenty nine patients were managed with one stage dorsal on lay buccal mucosal graft (BMG). Patients were followed up 3 monthly with history, physical examination and relevant investigations. The mean duration of follow up was 23 months. Result: The age of the patients ranged from18 years to 65 years with mean of 35years. The length of the stricture ranged from 2.5cm to 10 cm with mean length 5.5 cm. The mean duration operative period was 3.5 hours with range from 2 hours to 4.5 hours. Of the 29 patients, 15 patients (51.7%) had bulbar urethral stricture, 10 patients (34.5%) had penile urethral stricture and 4 patients (13.8) had pan urethralstricture. Success was defined as normal voiding without further procedure. The rate of recurrence noted in this study was 10.34%. Conclusion: One stage dorsal on lay BMG urethroplsaty is a reliable and satisfactory procedure for the management of long segment urethral stricture with minimum complication. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.68-73
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