New technique in harvesting urinary bladder mucosal graft for panurethral stricture reconstruction: A case report

Urethral stricture poses a challenge for reconstructive urologists particularly in cases involving panurethral disease, as treatment is vital for both urinary and sexual functions. While buccal mucosa grafts (BMGs) are the gold standard for urethral reconstruction, alternatives like penile skin, lingual mucosa and bladder mucosa are often used, particularly in cases of recurrent strictures or contraindications. Urinary bladder mucosal grafts (UBMGs) are ideal due to their histological properties, but conventional harvesting is invasive. This report introduces a novel, less invasive technique for harvesting UBMGs that is both affordable and accessible, showing promising outcomes.

A 40-year-old male patient presented with a 10-year history of nontraumatic urethral stricture disease. The patient had developed a panurethral stricture due to multiple unsuccessful internal urethrotomies and a failed BMG urethroplasty.

Given the patient's complex history and a 17 cm panurethral stricture, a decision was made to harvest a UBMG using a combination of transurethral endoscopic and laparoscopic techniques after obtaining informed consent, minimizing invasiveness.

This case report presents a minimally invasive technique for harvesting UBMG as a substitution for urethral reconstruction to treat complex urethral strictures. The method reduces invasiveness and improves access, offering a potential alternative to BMGs, especially for patients with previous failed repairs.