title: Lingual versus buccal mucosa graft urethroplasty for anterior urethral stricture: a prospective comparative analysis.
abstract: OBJECTIVE
  To compare lingual and buccal mucosa graft urethroplasty for anterior urethral stricture with respect to intraoperative, postoperative parameters and urethroplasty outcome.
  
  
  METHODS
  From January 2011 to December 2011, a total of 30 patients with anterior urethral stricture whereas group 2 underwent dorsal onlay buccal mucosa graft urethroplasty. Patients were evaluated for postoperative, tongue protrusion, oral opening, and difficulty in speech and swallowing pain score. Surgical outcome was evaluated with pre- and postoperative work-up involving retrograde urethrogram, uroflow and urethroscopy.
  
  
  RESULTS
  Mean age, stricture length and overall pain score were comparable in two groups. All the patients were mostly pain free by postoperative day 7. Group 1 patients had significant difficulty in speech and delayed return to normal diet as compared with group 2. The group 2 patients had a significant reduction in oral opening for the first week after surgery. In group 1, approximately 20% patients (with bilateral lingual grafts and stricture length >7 cm) complained of a change in speech character with restricted tongue movement in the long term, whereas there was no significant long-term morbidity in group 2. At mean follow up of 14.5 months, urethroplasty outcome was comparable in the two groups with one failure in group 1, and two failures in group 2.
  
  
  CONCLUSIONS
  Lingual mucosa graft urethroplasty provides outcomes equivalent to those of buccal mucosa graft urethroplasty. Postoperative morbidity and long-term change in speech make it a second choice for strictures >7 cm, only for cases where buccal mucosa graft is unavailable.
authors.affiliation: Department of Urology, Institute of Nephro-Urology, Bangalore, Karnataka, India.
authors.forename: Adittya K
authors.initials: AK
authors.lastname: Sharma
authors.forename: Ratkal
authors.initials: R
authors.lastname: Chandrashekar
authors.forename: Ramaiah
authors.initials: R
authors.lastname: Keshavamurthy
authors.forename: Girish G
authors.initials: GG
authors.lastname: Nelvigi
authors.forename: Ananth J
authors.initials: AJ
authors.lastname: Kamath
authors.forename: Satyam
authors.initials: S
authors.lastname: Sharma
authors.forename: G K
authors.initials: GK
authors.lastname: Venkatesh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014059:Tongue / Q000637:transplantation*; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D055815:Young Adult
keywords: buccal mucosa; lingual mucosa; urethral stricture; urethroplasty