Ventral onlay buccal mucosa urethroplasty: A 10-year experience

Matthew J. Mellon, Richard Bihrle

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: To report our experience, and to evaluate the long-term outcomes and complication profiles of ventral onlay buccal mucosal graft urethroplasty (BMU) after prior urological intervention. Methods: We retrospectively reviewed 114 consecutive patients between February 2001 and April 2009 who underwent buccal mucosal graft urethroplasty for recurrent anterior urethral stricture disease. Seven patients were excluded for incomplete data. The remaining 107 patients comprised the study cohort. The mean follow-up time was 39.3 months (range 6.6-127.3 months). All patients had prior urological attempts at operative management. Results: The mean stricture length was 3.14cm (range 1.0-8.0cm). Indications for buccal mucosal graft urethroplasty included: lichen sclerosis (2.8%), iatrogenic (24.3%), infection (4.7%) and perineal trauma/straddle injury (20.6%). Of these patients, 78 had bulbo-membranous stricture disease, 20 had penile involvement and nine were multifocal strictures. The average number of prior urological procedures was 2.83 (range 1-9). The overall graft failure rate was 6.5%. Importantly, the re-operation rate was 20.6%, primarily for stricture recurrence (18), meatal stenosis (3) and urethral diverticulum. The mean time to complication was 10.8 months. Conclusions: Ventral onlay buccal mucosal graft urethroplasty offers satisfactory results in the setting of recurrent and complicated urethral stricture disease. Graft failures and complications generally occur within the first year after surgery. Bulbar strictures enjoy greater graft patency and lower complication rates than other stricture locations. In particular, guarded expectations should be given for stricture length >4cm and multifocal disease.

Original languageEnglish
Pages (from-to)190-193
Number of pages4
JournalInternational Journal of Urology
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2014

Fingerprint

Inlays
antineoplaston A10
Mouth Mucosa
Pathologic Constriction
Transplants
Cheek
Urethral Stricture
Urethral Diseases
Lichen Sclerosus et Atrophicus
Diverticulum
Wounds and Injuries
Cohort Studies
Recurrence
Infection

Keywords

  • Buccal mucosa
  • Surgical outcomes
  • Urethra
  • Urethral stricture
  • Urethroplasty

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Ventral onlay buccal mucosa urethroplasty : A 10-year experience. / Mellon, Matthew J.; Bihrle, Richard.

In: International Journal of Urology, Vol. 21, No. 2, 01.02.2014, p. 190-193.

Research output: Contribution to journalArticle

@article{5735475fd34c4daca886c18c0f48712b,
title = "Ventral onlay buccal mucosa urethroplasty: A 10-year experience",
abstract = "Objective: To report our experience, and to evaluate the long-term outcomes and complication profiles of ventral onlay buccal mucosal graft urethroplasty (BMU) after prior urological intervention. Methods: We retrospectively reviewed 114 consecutive patients between February 2001 and April 2009 who underwent buccal mucosal graft urethroplasty for recurrent anterior urethral stricture disease. Seven patients were excluded for incomplete data. The remaining 107 patients comprised the study cohort. The mean follow-up time was 39.3 months (range 6.6-127.3 months). All patients had prior urological attempts at operative management. Results: The mean stricture length was 3.14cm (range 1.0-8.0cm). Indications for buccal mucosal graft urethroplasty included: lichen sclerosis (2.8{\%}), iatrogenic (24.3{\%}), infection (4.7{\%}) and perineal trauma/straddle injury (20.6{\%}). Of these patients, 78 had bulbo-membranous stricture disease, 20 had penile involvement and nine were multifocal strictures. The average number of prior urological procedures was 2.83 (range 1-9). The overall graft failure rate was 6.5{\%}. Importantly, the re-operation rate was 20.6{\%}, primarily for stricture recurrence (18), meatal stenosis (3) and urethral diverticulum. The mean time to complication was 10.8 months. Conclusions: Ventral onlay buccal mucosal graft urethroplasty offers satisfactory results in the setting of recurrent and complicated urethral stricture disease. Graft failures and complications generally occur within the first year after surgery. Bulbar strictures enjoy greater graft patency and lower complication rates than other stricture locations. In particular, guarded expectations should be given for stricture length >4cm and multifocal disease.",
keywords = "Buccal mucosa, Surgical outcomes, Urethra, Urethral stricture, Urethroplasty",
author = "Mellon, {Matthew J.} and Richard Bihrle",
year = "2014",
month = "2",
day = "1",
doi = "10.1111/iju.12236",
language = "English",
volume = "21",
pages = "190--193",
journal = "International Journal of Urology",
issn = "0919-8172",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Ventral onlay buccal mucosa urethroplasty

T2 - A 10-year experience

AU - Mellon, Matthew J.

AU - Bihrle, Richard

PY - 2014/2/1

Y1 - 2014/2/1

N2 - Objective: To report our experience, and to evaluate the long-term outcomes and complication profiles of ventral onlay buccal mucosal graft urethroplasty (BMU) after prior urological intervention. Methods: We retrospectively reviewed 114 consecutive patients between February 2001 and April 2009 who underwent buccal mucosal graft urethroplasty for recurrent anterior urethral stricture disease. Seven patients were excluded for incomplete data. The remaining 107 patients comprised the study cohort. The mean follow-up time was 39.3 months (range 6.6-127.3 months). All patients had prior urological attempts at operative management. Results: The mean stricture length was 3.14cm (range 1.0-8.0cm). Indications for buccal mucosal graft urethroplasty included: lichen sclerosis (2.8%), iatrogenic (24.3%), infection (4.7%) and perineal trauma/straddle injury (20.6%). Of these patients, 78 had bulbo-membranous stricture disease, 20 had penile involvement and nine were multifocal strictures. The average number of prior urological procedures was 2.83 (range 1-9). The overall graft failure rate was 6.5%. Importantly, the re-operation rate was 20.6%, primarily for stricture recurrence (18), meatal stenosis (3) and urethral diverticulum. The mean time to complication was 10.8 months. Conclusions: Ventral onlay buccal mucosal graft urethroplasty offers satisfactory results in the setting of recurrent and complicated urethral stricture disease. Graft failures and complications generally occur within the first year after surgery. Bulbar strictures enjoy greater graft patency and lower complication rates than other stricture locations. In particular, guarded expectations should be given for stricture length >4cm and multifocal disease.

AB - Objective: To report our experience, and to evaluate the long-term outcomes and complication profiles of ventral onlay buccal mucosal graft urethroplasty (BMU) after prior urological intervention. Methods: We retrospectively reviewed 114 consecutive patients between February 2001 and April 2009 who underwent buccal mucosal graft urethroplasty for recurrent anterior urethral stricture disease. Seven patients were excluded for incomplete data. The remaining 107 patients comprised the study cohort. The mean follow-up time was 39.3 months (range 6.6-127.3 months). All patients had prior urological attempts at operative management. Results: The mean stricture length was 3.14cm (range 1.0-8.0cm). Indications for buccal mucosal graft urethroplasty included: lichen sclerosis (2.8%), iatrogenic (24.3%), infection (4.7%) and perineal trauma/straddle injury (20.6%). Of these patients, 78 had bulbo-membranous stricture disease, 20 had penile involvement and nine were multifocal strictures. The average number of prior urological procedures was 2.83 (range 1-9). The overall graft failure rate was 6.5%. Importantly, the re-operation rate was 20.6%, primarily for stricture recurrence (18), meatal stenosis (3) and urethral diverticulum. The mean time to complication was 10.8 months. Conclusions: Ventral onlay buccal mucosal graft urethroplasty offers satisfactory results in the setting of recurrent and complicated urethral stricture disease. Graft failures and complications generally occur within the first year after surgery. Bulbar strictures enjoy greater graft patency and lower complication rates than other stricture locations. In particular, guarded expectations should be given for stricture length >4cm and multifocal disease.

KW - Buccal mucosa

KW - Surgical outcomes

KW - Urethra

KW - Urethral stricture

KW - Urethroplasty

UR - http://www.scopus.com/inward/record.url?scp=84907604663&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84907604663&partnerID=8YFLogxK

U2 - 10.1111/iju.12236

DO - 10.1111/iju.12236

M3 - Article

C2 - 23980634

AN - SCOPUS:84907604663

VL - 21

SP - 190

EP - 193

JO - International Journal of Urology

JF - International Journal of Urology

SN - 0919-8172

IS - 2

ER -