Urethroplasty with Lingual Mucosal Graft for Management of Long and Recurrent Strictures of the Anterior Urethra
Background: Currently, there is renewed controversy over which tissues and techniques are optimal for urethral replacement. Because surgical treatment of urethral stricture diseases is an evolving process, new technical refinements are continuously being suggested.
Objectives: To evaluate the efficacy and mid-term results of using lingual mucosal grafts (LMG) in management of long and recurrent strictures of the anterior urethra.
Patients and Methods: The study included 18 patients with long recurrent strictures of the anterior urethra. The recurrence arose in 14 patients after several visual internal urethrotomies, after hypospadias repair in 2, and after buccal mucosal graft (BMG) urethroplasty in 2. The strictures varied in length from 3 to 9 cm. Dorsal onlay of the LMGs was used in 12 patients, while ventral onlay was used in 6 patients. Follow-up lasted from 3 to 24 months. Postoperatively, all patients were followed by urethrography, uroflowmetry, and urethroscopy. Successful reconstruction criteria were a peak flow rate greater than 15 ml/sec and no need for postoperative dilatation.
Results: Out of 18 cases, 15 were successful (83.3%). Of the 3 failures, 1 patient had an urethrocutaneous fistula, and 2 patients developed recurrence in the stricture 3 months after urethroplasty.
Conclusion: The technique of substitution urethroplasty using lingual mucosal grafts has been shown to be easy, safe, and reproducible with good surgical and functional outcomes. The success rate is comparable to other techniques of substitution urethroplasty, especially BMGs, but with fewer donor site complications. Our mid-term results are satisfactory, but larger comparative studies with longer duration of follow-up are needed to confirm the durability of these results.
Keywords: LMG, BMG, Urethroplasty
Correspondence: Maged M Ragab, Urology Department, Tanta University Hospital, Tanta, Egypt,
To Cite this Article: Ragab MM, Elgamal S, Farhat Y, Saber W, Hawas M, Elsharaby M. Urethroplasty with Lingual Mucosal Graft for Management of Long and Recurrent Strictures of the Anterior Urethra. UIJ. In Press. doi:10.3834/uij.1939-4810.2008.12.02