Dorsal onlay buccal mucosal graft urethroplasty in the treatment of urethral strictures - Does the stricture length affect success?

Abstract

Background: Treatment of urethral strictures can be challenging, but, with appropriate preoperative evaluation and surgical planning it is possible to achieve successful results. Objectives: To analyze if the stricture length affects the success with dorsal onlay buccal mucosal graft urethroplasty technique. Material and Methods: Between January 2004 and June 2010 a total of 40 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤ 7 cm, and > 7 cm), and localization of the stricture were assessed as the factors affecting success rate. Results: The clinical outcome was defined as a failure when any operative instrumentation including dilatation was needed or the urine flow rate was less than 14 mL per second at the sixth month, postoperatively. The mean follow-up period was 43.44 months. Of 40 patients, 28 (70%) were successful and 12 (30%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p = 0.26 and p = 0.41). The statistical difference was significant for the localization and length of the stricture by means of success (p = 0.002 and p = 0.025). Conclusions: Our results show that the stricture length and localization are the most important variables for desirable success. Even though surgical techniques are constantly evolving, long strictures stay as a problem for urologists. Studies with larger number of patients with long urethral strictures may support our findings, and may prove the efficiency of these surgical techniques.