Dorsal onlay buccal mucosal graft urethroplasty in the treatment of urethral strictures - does the stricture length affect success?
BACKGROUND
Treatment of urethral strictures can be challenging, but, with appropriate preoperative evaluation and surgical planning it is possible to achieve successful results.


OBJECTIVE
To analyze if the stricture length affects the success with dorsal onlay buccal mucosal graft urethroplasty technique.


METHODS
Between January 2004 and June 2010 a total of 40 patients with anterior urethral stricture were treated with dorsal onlay buccal mucosal graft urethroplasty. Age, etiology of the stricture, stricture length (≤7 cm, and >7 cm), and localization of the stricture were assessed as the factors affecting success rate.


RESULTS
The clinical outcome was defined as a failure when any operative instrumentation including dilatation was needed or the urine flow rate was less than 14 mL per second at the sixth month, postoperatively. The mean follow-up period was 43.44 months. Of 40 patients, 28 (70%) were successful and 12 (30%) were a failure. There was no statistically significant difference between the age groups, etiology of the stricture and success rate (p=0.26 and p=0.41). The statistical difference was significant for the localization and length of the stricture by means of success (p=0.002 and p=0.025).


CONCLUSIONS
Our results show that the stricture length and localization are the most important variables for desirable success. Even though surgical techniques are constantly evolving, long strictures stay as a problem for urologists. Studies with larger number of patients with long urethral strictures may support our findings, and may prove the efficiency of these surgical techniques.
Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Urology Clinic, Ankara, Turkey.
Fatih
F
Yalcinkaya
Department of Urology, Faculty of Medicine, Bozok University, Yozgat, Turkey.
Kursad
K
Zengin
Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Urology Clinic, Ankara, Turkey.
Nurettin
N
Sertcelik
Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Urology Clinic, Ankara, Turkey.
Orhan
O
Yigitbasi
Department of Urology, Karaman State Hospital, Karaman, Turkey.
Halil
H
Bozkurt
Department of Urology, Sivas Numune Hospital, Sivas, Turkey.
Tevfik
T
Sarikaya
Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Urology Clinic, Ankara, Turkey.
Raif
R
Karabacak
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D018579:Patient Selection; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult