[Redo urethroplasty with buccal mucosa]

Area of Science:

• Urology
• Surgical Reconstruction

Background:

• Urethral strictures significantly impact quality of life, affecting 0.6% of males in industrialized nations.
• Causes include trauma, infection, iatrogenic factors, and idiopathic origins.
• Treatment has shifted towards complex open surgical reconstruction.

Purpose of the Study:

• To review current treatment options for urethral strictures.
• To evaluate success rates and risk factors for recurrence.
• To discuss management strategies for recurrent strictures.

Main Methods:

• Review of current literature on urethral stricture treatment.
• Analysis of success rates for primary and redo urethroplasty.
• Identification of risk factors for stricture recurrence.

Main Results:

• Excision and primary end-to-end anastomosis or buccal mucosa graft urethroplasty achieve >80% success.
• Penile location, stricture length >4 cm, and prior endoscopic therapy are risk factors for recurrence.
• Redo urethroplasty shows high success rates comparable to primary procedures for recurrent strictures.

Conclusions:

• Redo urethroplasty is the preferred choice for recurrent urethral strictures, offering high success and patient satisfaction.
• While primary buccal mucosa grafting has oral morbidity, repeated grafting in redo urethroplasty shows only slightly increased complications.
• Understanding recurrence risk factors guides optimal treatment selection.