Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience
Objective: To describe the safety, feasibility and outcome of redo buccal mucosal graft urethroplasty in patients presenting with recurrent anterior urethral stricture following previous failed BMG urethroplasty. Materials and Methods: This was a retrospective chart review of 21 patients with recurr...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2016-01-01
|
| Series: | Urology Annals |
| Subjects: | |
| Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2016;volume=8;issue=1;spage=31;epage=35;aulast=Javali |
| _version_ | 1811203159427645440 |
|---|---|
| author | Tarun Dilip Javali Amit Katti Harohalli K Nagaraj |
| author_facet | Tarun Dilip Javali Amit Katti Harohalli K Nagaraj |
| author_sort | Tarun Dilip Javali |
| collection | DOAJ |
| description | Objective: To describe the safety, feasibility and outcome of redo buccal mucosal graft urethroplasty in patients presenting with recurrent anterior urethral stricture following previous failed BMG urethroplasty.
Materials and Methods: This was a retrospective chart review of 21 patients with recurrent anterior urethral stricture after buccal mucosal graft urethroplasty, who underwent redo urethroplasty at our institute between January 2008 to January 2014. All patients underwent preoperative evaluation in the form of uroflowmetry, RGU, sonourethrogram and urethroscopy. Among patients with isolated bulbar urethral stricture, who had previously undergone ventral onlay, redo dorsal onlay BMG urethroplasty was done and vice versa (9+8 patients). Three patients, who had previously undergone Kulkarni-Barbagli urethroplasty, underwent dorsal free graft urethroplasty by ventral sagittal urethrotomy approach. One patient who had previously undergone urethroplasty by ASOPA technique underwent 2-stage Bracka repair. Catheter removal was done on 21st postoperative day. Follow-up consisted of uroflow, PVR and AUA-SS. Failure was defined as requirement of any post operative procedure.
Results: Idiopathic urethral strictures constituted the predominant etiology. Eleven patients presented with stricture recurrence involving the entire grafted area, while the remaining 10 patients had fibrotic ring like strictures at the proximal/distal graft-urethral anastomotic sites. The success rate of redo surgery was 85.7% at a mean follow-up of 41.8 months (range: 1 yr-6 yrs). Among the 18 patients who required no intervention during the follow-up period, the graft survival was longer compared to their initial time to failure.
Conclusion: Redo buccal mucosal graft urethroplasty is safe and feasible with good intermediate term outcomes. |
| first_indexed | 2024-04-12T02:51:02Z |
| format | Article |
| id | doaj.art-a45baa756d12444687ba90c7413bf5c4 |
| institution | Directory Open Access Journal |
| issn | 0974-7796 0974-7834 |
| language | English |
| last_indexed | 2024-04-12T02:51:02Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urology Annals |
| spelling | doaj.art-a45baa756d12444687ba90c7413bf5c42022-12-22T03:51:00ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342016-01-0181313510.4103/0974-7796.162217Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experienceTarun Dilip JavaliAmit KattiHarohalli K NagarajObjective: To describe the safety, feasibility and outcome of redo buccal mucosal graft urethroplasty in patients presenting with recurrent anterior urethral stricture following previous failed BMG urethroplasty. Materials and Methods: This was a retrospective chart review of 21 patients with recurrent anterior urethral stricture after buccal mucosal graft urethroplasty, who underwent redo urethroplasty at our institute between January 2008 to January 2014. All patients underwent preoperative evaluation in the form of uroflowmetry, RGU, sonourethrogram and urethroscopy. Among patients with isolated bulbar urethral stricture, who had previously undergone ventral onlay, redo dorsal onlay BMG urethroplasty was done and vice versa (9+8 patients). Three patients, who had previously undergone Kulkarni-Barbagli urethroplasty, underwent dorsal free graft urethroplasty by ventral sagittal urethrotomy approach. One patient who had previously undergone urethroplasty by ASOPA technique underwent 2-stage Bracka repair. Catheter removal was done on 21st postoperative day. Follow-up consisted of uroflow, PVR and AUA-SS. Failure was defined as requirement of any post operative procedure. Results: Idiopathic urethral strictures constituted the predominant etiology. Eleven patients presented with stricture recurrence involving the entire grafted area, while the remaining 10 patients had fibrotic ring like strictures at the proximal/distal graft-urethral anastomotic sites. The success rate of redo surgery was 85.7% at a mean follow-up of 41.8 months (range: 1 yr-6 yrs). Among the 18 patients who required no intervention during the follow-up period, the graft survival was longer compared to their initial time to failure. Conclusion: Redo buccal mucosal graft urethroplasty is safe and feasible with good intermediate term outcomes.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2016;volume=8;issue=1;spage=31;epage=35;aulast=JavaliBuccal mucosal graft-urethroplastyrecurrent anterior urethral stricturesredo surgery |
| spellingShingle | Tarun Dilip Javali Amit Katti Harohalli K Nagaraj Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience Urology Annals Buccal mucosal graft-urethroplasty recurrent anterior urethral strictures redo surgery |
| title | Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience |
| title_full | Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience |
| title_fullStr | Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience |
| title_full_unstemmed | Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience |
| title_short | Management of recurrent anterior urethral strictures following buccal mucosal graft-urethroplasty: A single center experience |
| title_sort | management of recurrent anterior urethral strictures following buccal mucosal graft urethroplasty a single center experience |
| topic | Buccal mucosal graft-urethroplasty recurrent anterior urethral strictures redo surgery |
| url | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2016;volume=8;issue=1;spage=31;epage=35;aulast=Javali |
| work_keys_str_mv | AT tarundilipjavali managementofrecurrentanteriorurethralstricturesfollowingbuccalmucosalgrafturethroplastyasinglecenterexperience AT amitkatti managementofrecurrentanteriorurethralstricturesfollowingbuccalmucosalgrafturethroplastyasinglecenterexperience AT harohalliknagaraj managementofrecurrentanteriorurethralstricturesfollowingbuccalmucosalgrafturethroplastyasinglecenterexperience |