title: Buccal mucosa urethroplasty: a 10-year retrospective review of maxillofacial and urological outcomes.
abstract: BACKGROUND
  Reconstruction of a urethral stricture poses a difficult surgical problem. Anastomotic repair remains the gold standard. Strictures longer than 2 cm may require substitution urethroplasty. This is a retrospective review of all patients who underwent urethral reconstruction with an autologous free buccal mucosa graft at a Regional hospital between 1998 and 2009.
  
  
  METHODS
  Variables recorded included; demographics: patient gender/age; follow-up period. Urology: pre-operative diagnosis/aetiology; presenting complaint; previous urological surgery, pre-operative retrograde urethrogram, stricture length, graft size, operative time/blood loss, morbidity, complications. Maxillofacial: pre-/post-operative inter-incisal opening, patency of Stenson's parotid duct, ipsilateral parotid swelling, sensory nerve deficit.
  
  
  RESULTS
  A total of eight male patients were included. Mean age was 33 years. Two patients had one-stage dorsal onlay urethroplasty, and the remaining six had a two-stage BMG urethroplasty. All patients underwent a urethrogram 20 days post-operatively, which demonstrated no leak, and a good caliber grafted urethra in all cases. A flexible cystoscopy scope was accommodated in all patients 8 weeks post-operatively. Mean follow-up was 42 months. At long-term follow-up, there was no evidence of stricture formation, and all patients were voiding well. There were no long-term intra-oral complications.
  
  
  CONCLUSIONS
  This study suggests that anterior urethral strictures up to 6 cm in length may be predictably and safely managed with buccal mucosal urethroplasty. The buccal mucosa is easy to harvest, and can be used successfully in one- and two-stage grafting procedures. The rate of complications, from both a urological and maxillofacial perspective, in the group of patients studied was low.
authors.affiliation: Department of Oral and Maxillofacial Surgery, St James Hospital, Dublin, Ireland. johnedoconnell@yahoo.com.
authors.forename: J E
authors.initials: JE
authors.lastname: O'Connell
authors.affiliation: Department of Urology, Mid Western Regional Hospital, Limerick, Ireland.
authors.forename: I M
authors.initials: IM
authors.lastname: Cullen
authors.affiliation: Department of Oral and Maxillofacial Surgery, St James Hospital, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Murphy
authors.affiliation: Department of Urology, Mid Western Regional Hospital, Limerick, Ireland.
authors.forename: H
authors.initials: H
authors.lastname: Flood
authors.affiliation: Department of Oral and Maxillofacial Surgery, St James Hospital, Dublin, Ireland.
authors.forename: G J
authors.initials: GJ
authors.lastname: Kearns
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014945:Wound Healing; D055815:Young Adult
keywords: Buccal mucosa; Free grafts; Urethral stricture; Urethroplasty