Buccal mucosal graft in repeat urethroplasty

Area of Science:

• Urology
• Regenerative Medicine
• Surgical Innovation

Background:

• Urethral stricture is a significant cause of morbidity, often requiring multiple surgical interventions.
• Previous urethroplasties and internal urethrotomies have high failure rates.
• Recurrent urethral strictures pose a challenge in reconstructive urology.

Purpose of the Study:

• To evaluate the efficacy of tubed buccal mucosal grafts in repeat urethroplasty for urethral stricture.
• To assess the outcomes of buccal mucosal graft urethroplasty in patients with a history of failed surgeries.
• To determine the success rate and functional improvement following this reconstructive technique.

Main Methods:

• Ten patients (12-47 years) with recurrent urethral strictures underwent repeat urethroplasty using tubed buccal mucosal grafts.
• Buccal mucosa was harvested, tubed, and interposed into the excised stricture defect.
• Patients were monitored for 1, 6, and 12 months postoperatively.

Main Results:

• The procedure was technically successful in all patients, with a mean operative time of 150 minutes.
• Significant improvement in urinary flow rate was observed (0 to 10.4 mL/s, P = .018).
• Stricture recurrence occurred in 3 patients, primarily those with longer defects (>5 cm) and multiple prior failed surgeries.

Conclusions:

• Tubed buccal mucosal graft urethroplasty is a resilient and effective option for treating anterior and posterior urethral strictures, especially those longer than 3 cm.
• This technique offers a viable solution for complex cases with failed previous operations.
• The graft's ease of harvesting and lack of scarring make it an optimal substitute.