Buccal mucosa: is it ideal for long segment stricture urethroplasty?

  • Dr. Atul Kumar Assistant Professor, Government Medical College, Ratlam (M.P.) India
  • Dr. Praveen Singh Baghel Associate Professor, Department of Surgery, Government Medical College, Ratlam, Madhya Pradesh, India
  • Dr. Shabbir Hussain Consultant Urologist, Global Hospital & Urology Research Center, India
  • Dr. Fanindra Singh Solanki Associate Professor, Department of Surgery, NSCB MCH Jabalpur, Madhya Pradesh, India
  • Dr. Deepti Bala Sharma Professor, Department of Surgery, NSCB MCH Jabalpur, Madhya Pradesh, India
DOI: https://doi.org/10.17511/ijoso.2019.i03.13
Keywords: Graft shrinkage, Stricture formation, Balanitis xerotica obliterens (BXO) buccal mucosal graft Urethroplasty (BMGU)

Abstract

Background: Reconstruction of male urethra poses a continuing urological challenge. The ideal material for substitution urethroplasty remains controversial. Candidate tissues have included split and full thickness skin graft from scrotum, penis and extra-genital areas like bladder mucosa and buccal mucosa. This study was done to evaluate the short term and long-term results of buccal mucosal urethroplasty and analyzed them with different variables like etiology of stricture, length of stricture, operative procedure and associated complications and success rate.

Material and Methods: All the Cases of anterior stricture urethra who had stricture length more than 1 cm and who underwent buccal mucosal substitution urethroplasty were included in this study. The short term and long-term results of buccal mucosal substitution urethroplasty were assessed. Patients were divided into two groups according to their length, patients with stricture length up to 6 cm and 7 cm or more and the results of buccal mucosal substitution urethroplasty were assessed in terms of etiology of stricture, length of stricture, operative procedure and its associated complications and success rate.

Results: In the present study, the success rate of long segment strictures was inferior (77%). The success rate of two staged BMGU for long segment strictures was satisfactory (80%) if not associated with proximal urethral stenosis. Success rate of urethral strictures associated with BXO was lower (75%) as compared to others. Success rate of BMGU with almost tube (50%) was very poor.

Conclusion: Buccal mucosa gives a good and viable option for substitution urethroplasty for long segment stricture. It is easy to harvest and handle, is resilient to infections and accustomed to a wet environment. As of date, it provides good material for substitution for treating all types of strictures with fairly good results and fewer complications.

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CITATION
DOI: 10.17511/ijoso.2019.i03.13
Published: 2019-08-31
How to Cite
Kumar, A., Singh Baghel, P., Hussain, S., Singh Solanki, F., & Bala Sharma, D. (2019). Buccal mucosa: is it ideal for long segment stricture urethroplasty?. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 5(3), 213-221. https://doi.org/10.17511/ijoso.2019.i03.13
Issue
Vol 5 No 3 (2019): Jul-Aug
Section
Original Article