Johanson's Stage II Urethroplasty with Inlay Buccal Mucosal Graft

Area of Science:

• Urology
• Reconstructive Surgery

Background:

• Urethral stricture disease presents significant reconstructive challenges, especially for long-segment strictures or those linked to lichen sclerosus.
• Staged urethroplasty is a recognized approach for complex urethral reconstruction.

Purpose of the Study:

• To evaluate the outcomes of Johanson's Stage II urethroplasty utilizing inlay buccal mucosal grafts.
• To assess functional results and complications in patients undergoing staged urethroplasty for complex urethral strictures.

Main Methods:

• Retrospective review of patients who completed Stage I and underwent Stage II urethroplasty.
• Inlay buccal mucosal grafts were employed for urethral augmentation in selected cases.
• Preoperative assessment included uroflowmetry and retrograde urethrography; postoperative follow-up assessed outcomes and complications.

Main Results:

• Successful voiding was achieved in 90% of patients post-procedure.
• Postoperative maximum urinary flow rates exceeded 15 mL/s in the majority of cases.
• Minor complications occurred in two patients, managed conservatively; cosmetic and sexual function outcomes were generally satisfactory.

Conclusions:

• Staged urethroplasty with buccal mucosal graft augmentation is a gold-standard technique for managing complex urethral strictures.
• This approach yields excellent functional outcomes and durable results for patients with challenging urethral conditions.