Buccal mucosal graft urethroplasty in the treatment of urethral strictures

Experience using the two-surgeon technique

Angela M. Arlen, Charles Powell, Henry T. Hoffman, Karl J. Kreder

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases). Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%). The single-stage buccal graft success rate was 86.4% (19 of 22 cases). Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%), including superficial wound infection (one), superficial wound dehiscence (two), and abscess/fistula formation requiring reoperation (one). The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalTheScientificWorldJournal
Volume10
DOIs
StatePublished - Jan 8 2010
Externally publishedYes

Fingerprint

Urethral Stricture
Cheek
Grafts
Pathologic Constriction
Transplants
Operative Time
Repair
Anesthesia
repair
Urethral Diseases
etiology
Substitution reactions
Therapeutics
Recurrence
Cystoscopy
Tissue
Mouth Mucosa
Wound Infection
substitution
Reoperation

Keywords

  • Mouth mucosa
  • Reconstructive surgical procedures
  • Transplants
  • Urethral stricture
  • Urologic surgical procedures

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Environmental Science(all)
  • Medicine(all)

Cite this

Buccal mucosal graft urethroplasty in the treatment of urethral strictures : Experience using the two-surgeon technique. / Arlen, Angela M.; Powell, Charles; Hoffman, Henry T.; Kreder, Karl J.

In: TheScientificWorldJournal, Vol. 10, 08.01.2010, p. 74-79.

Research output: Contribution to journalArticle

@article{de323da6b423422f8cf5f22cfe5a0985,
title = "Buccal mucosal graft urethroplasty in the treatment of urethral strictures: Experience using the two-surgeon technique",
abstract = "At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3{\%} (20 of 24 cases). Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50{\%}). The single-stage buccal graft success rate was 86.4{\%} (19 of 22 cases). Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6{\%}), including superficial wound infection (one), superficial wound dehiscence (two), and abscess/fistula formation requiring reoperation (one). The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.",
keywords = "Mouth mucosa, Reconstructive surgical procedures, Transplants, Urethral stricture, Urologic surgical procedures",
author = "Arlen, {Angela M.} and Charles Powell and Hoffman, {Henry T.} and Kreder, {Karl J.}",
year = "2010",
month = "1",
day = "8",
doi = "10.1100/tsw.2010.16",
language = "English (US)",
volume = "10",
pages = "74--79",
journal = "The Scientific World Journal",
issn = "2356-6140",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - Buccal mucosal graft urethroplasty in the treatment of urethral strictures

T2 - Experience using the two-surgeon technique

AU - Arlen, Angela M.

AU - Powell, Charles

AU - Hoffman, Henry T.

AU - Kreder, Karl J.

PY - 2010/1/8

Y1 - 2010/1/8

N2 - At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases). Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%). The single-stage buccal graft success rate was 86.4% (19 of 22 cases). Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%), including superficial wound infection (one), superficial wound dehiscence (two), and abscess/fistula formation requiring reoperation (one). The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

AB - At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases). Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%). The single-stage buccal graft success rate was 86.4% (19 of 22 cases). Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%), including superficial wound infection (one), superficial wound dehiscence (two), and abscess/fistula formation requiring reoperation (one). The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

KW - Mouth mucosa

KW - Reconstructive surgical procedures

KW - Transplants

KW - Urethral stricture

KW - Urologic surgical procedures

UR - http://www.scopus.com/inward/record.url?scp=77749304239&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77749304239&partnerID=8YFLogxK

U2 - 10.1100/tsw.2010.16

DO - 10.1100/tsw.2010.16

M3 - Article

VL - 10

SP - 74

EP - 79

JO - The Scientific World Journal

JF - The Scientific World Journal

SN - 2356-6140

ER -