An institutional experience on comparison of different Onlay approaches for urethroplasty using buccal mucosal graft

Abstract

Urethral stricture is a common disease encountered by urologist. Reconstruction of long and complex urethral strictures is technically demanding. BMG augmentation urethroplasty has become the standard of care for long urethral strictures. It is readily available and easily harvested with minimal donor site morbidity. Buccal mucosa is hairless, has a thin, elastin rich epithelium giving it excellent handling characteristics and a highly vascular lamina propria, which facilitates harvesting and imbibition. Whether to place the graft dorsally, ventrally or laterally is controversial. We conducted this Prospective study, between August 2009 and December 2011. We selected 25 cases of long anterior urethral strictures and were managed by onlay urethroplasty by different approaches. Follow up was done for 8- 20 months. 3 patients lost follow up after first visit. Post operative uroflowmetry was done in all patients after 1 month at the time of first follow up visit. Of 25 cases 21 (84%) were successful and 4 (16%) failed. In terms of success, not much significant difference was found between different approaches