V12-10: Dorsal and ventral buccal grafts for bulbar urethral strictues with unilateral mobilization
Bulbar urethral strictures not amenable to excision and primary anastomosis require tissue transfer by grafts. Onlay graft placement can be impractical in obliterative and nearly obliterative bulbar stricures. we report a technique of dorsal and ventral buccal grats placement in obliterative strictures of bulabar urethra with unilateral mobilisation of bulbar urethra.
15 patients with obliterative and nearly obliterative bulbar strictures underwent double buccal grafts placement ventrall and dorsally after excision of most narrowed stricture segment with partial spongiofibrosis, with unilateral mobilisation of bulbar urethra. 12-16 mm wide graft was placed ventrally after transection of most narrowed stricture segment with partial spongiofibrosis and 15 -20 mm graft was placed dorsally to get urethral calibre of 30F.
12 patients had followup of more than 1 year. All patients had MCU and urethroscopy during catheter removal at 3-4 weeks.Patients were followed by symptoms score, urinary flow rates at regular intervals. One patient had annular narrowing at proximal anastomotic site and underwent dilatation at 3 months. At followup of 14 months flow rates are maintained.
Dorsal and ventral placement of buccal grafts provides an option of single stage reconstruction of obliterative bulbar urethral strictures without complete transection of urethra.