Double-face augmentation urethroplasty for bulbar urethral strictures: Analysis of short-term outcomes

Abstract

Objective: To present our initial experience with double-face augmentation urethroplasty for near-obliterative bulbar urethral strictures and analyze the short-term outcomes. Material and methods: We retrospectively evaluated a prospectively maintained database of patients with near-obliterative bulbar urethral strictures (>2 cm), who underwent double-face augmentation urethroplasty. The patients’ demographic characteristics, clinical data, and data regarding the investigations conducted were analyzed. Near-obliterative urethral stricture was defined as lumen <6 Fr. Double-face urethroplasty was performed using a ventral approach, during which dorsal inlay and ventral onlay buccal mucosal graft (BMG) augmentation were performed. A successful outcome was defined as normal voiding without the need for any instrumentation to improve the urinary flow rate. Results: A total of 37 patients with a mean age of 50±11.7 years, who underwent this procedure were included in the study. The mean stricture length was 5.2±0.95 cm. The mean length of the dorsal inlay BMG augmentation was 3.1±0.5 cm and that of the ventral onlay BMG augmentation was 6.3±1.2 cm. Post-void dribbling (18.9%) was the most commonly reported complication. The maximum flow rates and symptom scores significantly improved in both groups compared with the preoperative parameters (p<0.001). The incidence of both erectile dysfunction and ejaculatory failure was reported in 6 (16.2%) patients; respectively. The overall success rate was 86.5% at a median follow-up period of 36 months (IQR: 26.5–43). Conclusion: Double-face augmentation urethroplasty is a safe and feasible option for near-obliterative bulbar urethral strictures, and our study showed satisfactory short-term outcomes for the same.