Indian Journal of Urology Users online:2099  
IJU
Home Current Issue Ahead of print Editorial Board Archives Symposia Guidelines Subscriptions Login 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size


 
UROSCAN
Year : 2006  |  Volume : 22  |  Issue : 2  |  Page : 165-166
 

Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: Are results affected by the surgical technique?


Departments of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

Correspondence Address:
Rajiv Goyal
Departments of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

 

How to cite this article:
Goyal R, Dubey D, Srivastav A. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: Are results affected by the surgical technique?. Indian J Urol 2006;22:165-6

How to cite this URL:
Goyal R, Dubey D, Srivastav A. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: Are results affected by the surgical technique?. Indian J Urol [serial online] 2006 [cited 2019 Oct 21];22:165-6. Available from: http://www.indianjurol.com/text.asp?2006/22/2/165/26585

Guido B, Enzo P, Giorgio G, Francesco M, Damiano T and Massimo L. J Urol 174, 2005; 955-8.



   Summary Top


Buccal mucosa graft onlay presents one of the most widespread methods for the repair of strictures in the bulbar urethra, because of its thick and highly vascular spongiosum tissue. The graft may be placed on the ventral or dorsal urethral surface, according to the surgeon's experience and preference. The authors investigated the effect of the surgical technique on the outcome of 3 types of bulbar urethroplasty, using buccal mucosa. They included 50 patients who were treated for bulbar urethral strictures by use of buccal mucosa, over a period of 6 years. The graft was placed on the ventral, dorsal and lateral surface in 17, 27 and 6 cases, respectively. The outcome was considered a success or failure at the time that any post-operative procedure was needed, including dilatation. 42 (84%) were successful and 8 (16%) failed. The success rate of ventral onlay, dorsal onlay and laterally placed grafts was 84, 85 and 83%, respectively. Failures were treated with urethrotomy in 5 cases and 2-stage urethroplasty in 3 cases. The authors conclude that the site of placement of the buccal graft did not affect the outcome.


   Comments Top


In this retrospective analysis, the authors have evaluated the effect of site of buccal mucosa graft placement on the outcome of the surgical technique. Almost similar success rates have been reported with each of these techniques. Placing a graft dorsally on the urethra is simpler and safer in the distal part of the bulbar urethra, whereas the ventral placement of the graft is more efficacious in the proximal part of the bulbar urethra, where the spongiosum tissue is thicker and better vascularized. In patients who have long urethral strictures located in the entire bulb, the lateral opening of the urethral surface can avoid the pitfalls of ventral and dorsal urethrotomy. Graft failure in distal anastomosis where the spongiosum is less vascular, may represent poor inosculation due to poor graft bed vascularity, whereas failure at the proximal anastomotic site is contributed to the under- staging of the disease during treatment.[1] Urethrocele with post void dribbling and semen sequestration, are more common in patients with ventral onlay mucosa placement.[2]

Although the authors have critically evaluated the outcome of different approaches to bulbar urethral stricture reconstruction with buccal mucosa, a selection bias was introduced, based on the location of the stricture. A randomized prospective trial is needed to confirm these observations.

 
   References Top

1.Elliot SP, Metro MJ, Mc Aninch JW. Long term follow up of the ventrally placed buccal mucosa onlay graft in bulbar urethral reconstruction. J Urol 2003;169:1754-8.  Back to cited text no. 1    
2.Dubey D, Kumar A, Bansal P, Srivastava A, Kapoor R, Mandhani A. substitution urethroplasty for anterior urethral strictures: a critical appraisal of various techniques. BJU Int 2003;91:215-8.  Back to cited text no. 2    




 

Top
Print this article  Email this article
Previous article Next article

    

 
   Search
 
   Next article
   Previous article 
   Table of Contents
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (78 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Summary
    Comments
    References

 Article Access Statistics
    Viewed3970    
    Printed50    
    Emailed0    
    PDF Downloaded142    
    Comments [Add]    

Recommend this journal

HEALTHWARE INDIA