OUTCOMES OF DORSAL ONLAY VERSUS VENTRAL ONLAY BUCCAL MUCOSAL GRAFT URETHROPLASTY IN PATIENTS OF BULBAR URETHRAL STRICTURE

Urethral stricture is a chronic and common urological problem and difficult to manage fraught with high patient morbidity and stricture recurrence. Buccal mucosal graft (BMG) has become an ideal urethral substitute because of the ease of harvest and surgical handling characteristics. Because of these unique characteristics, buccal mucosa has gained popularity in the realm of reconstructive urology. BMGs can be placed dorsally or ventrally. There has been controversy over which surgical technique is the most appropriate for its application.

130 patients with a diagnosis of bulbar urethral stricture having stricture length more than 2cm were included in this study and divided into two groups for BMG urethrethoroplasty (Group 1: Ventral onlay technique and Group 2: Dorsal onlay technique). Post-procedural Uroflowmetry and post-void volume estimation were done after 3 months of surgery to determine the success rate. Chi-square test was used to compare the success rate in group 1 and group 2 patients. P-value <0.05 was taken as a significant difference.

The Mean age of patients was 39.39±8.56 years, body mass index of 24.51±3.75 kg/m².  And the length of the bulbar stricture was 3.55±0.94 cm. On a Comparison of success rate between the groups, the procedure was successful in 61 (93.8%) in the ventral onlay BMG group versus in 50 (76.9%) patients in dorsal onlay BMG group (p-value 0.006).

According to the present study results, ventral onlay buccal mucosal graft (BMG) urethroplasty has a higher success rate as compared to the dorsal onlay BMG urethroplasty. So ventral onlay BMG urethroplasty can be adopted as a preferred technique for the management of bulbar urethral stricture.

Keywords: Bulbar urethral stricture, buccal mucosal graft, urethroplasty.