OPTIMAL TREATMENT IN RECURRENT URETHRAL STRICTURES
Abstract:
The objective of this paper is to discuss about the advantages and disadvantages of buccal mucosa as biological material of substitution in urethral plasty through the experience of the Urology Clinic of Sibiu. We conducted a clinical trial on a clinical series of 41 patients who were diagnosed with recurrent urethral strictures in 2009-2013 and operated using buccal mucosa for urethral lumen augmentation. Urethral strictures were evaluated in terms of etiology, topography and length. Harvesting buccal mucosa was performed in 38 patients at the vestibular level and, at lingual level in 3 patients. Urethroplasty with dorsal onlay graft was performed in 23 cases, ventral onlay graft in 9 cases, dorsal inlay graft urethroplasty in 6 patients and tubularization in 3 patients (7.32 %). The mean duration of follow-up of patients was 7.2 months. The research has shown that buccal mucosa graft is the golden standard in urethral reconstruction with remarkable biological, histological and mechanical properties. Buccal mucosa graft urethroplasty requires a well-trained surgical team with multidisciplinary skills. The accomplishment of urethroplasty with two teams halves the secondary operating time and the complications related to anesthesia. The surgical technique suitable for the type of urethral stricture is an essential requirement in order to achieve a functional and esthetic result.
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