Two-staged urethroplasty: buccal mucosa and mesh graft techniques.
OBJECTIVE
The purpose of this study was to describe indications, the operative technique and results of the two-staged buccal mucosa (BM) and mesh graft urethroplasty for treatment of urethral strictures.


METHODS
Between 3/1993 and 12/1999, urethral reconstructions were performed in 267 consecutive patients (group I), including 68 mesh graft urethroplasties (25 %) and 30 BM urethroplasties (12 %). Between 1/2000 and 8/2004, additional 249 urethroplasties were performed: Of those, 12% were mesh graft and 50% BM urethroplasties (group II).


RESULTS
In patient group I, stricture recurrence was found to be the main complication of both procedures (BM 17 %, mesh 16 %). However, erectile dysfunction and curvature only occurred in the mesh graft group with 4% and 9 %, respectively. Patient satisfaction was high in both groups (BM 96.7%, mesh 83.3%). Between 1/2000 and 8/2004 (group II) the number of BM urethroplasties increased to 50%, whereas the number of mesh graft urethroplasty decreased (12%). More than 80% of the patients were satisfied with the results.


CONCLUSIONS
Long strictures with severe spongiofibrosis represent an indication for two staged urethro-plasty (BM and mesh graft). Excellent results can be achieved with both techniques with a similar rate of complications. The mesh graft technique remains the last option for a complex patient group.
Pfalzgraf
D
D
Asklepios Klinik Harburg, Hamburg, Germany. dpfalzgr@uke.uni-hamburg.de
Olianas
R
R
Schreiter
F
F
Fisch
M
M
D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D013524:Surgical Flaps; D013526:Surgical Mesh; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*