title: Substitution urethroplasty is as successful as anastomotic urethroplasty for short bulbar strictures.
abstract: BACKGROUND
  To evaluate the efficacy of transecting anastomotic urethroplasty (AU) and buccal mucosa graft (BMG) ventral onlay substitution urethroplasty (SU) in treating short bulbar urethral strictures.
  
  
  METHODS
  Sixty patients underwent either AU or SU for bulbar strictures of similar length with follow up of at least 12 months. Follow up included clinical history, uroflowmetry, and ultrasound post-void residuals (PVR) performed every 4 months for the first year and yearly thereafter.
  
  
  RESULTS
  Out of 131 patients with short bulbar strictures, 40 were treated with BMG onlay SU and 20 had AU. Median follow up in the SU group was 57 months (IQR 27-76) and 120 months (IQR 109-130) in the AU group. The median stricture length was 3 cm (IQR 2.5-3.0) in the SU group and 1.3 cm (IQR 1-2) in the AU group (p < 0.001). The 3 year freedom from intervention was 93% in the SU group, and 85% in the AU group (p = 0.72).
  
  
  CONCLUSIONS
  BMG onlay ventral urethroplasty has similar success rates to anastomotic urethroplasty for short bulbar urethral strictures. Due to the relatively fewer complications reported after substitution urethroplasty with BMG, it should be considered the treatment of choice for short bulbar urethral strictures.
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Mang L
authors.initials: ML
authors.lastname: Chen
authors.forename: Brian D
authors.initials: BD
authors.lastname: Odom
authors.forename: Richard A
authors.initials: RA
authors.lastname: Santucci
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery / Q000637:transplantation; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D016378:Tissue Transplantation; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology* / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods*