title: Primary dorsal buccal mucosa graft urethroplasty for anterior urethral strictures in patients with lichen sclerosus.
abstract: OBJECTIVE
  To report our ongoing experience with dorsal buccal mucosa graft (BMG) urethroplasty for the primary repair of anterior urethral strictures in patients with lichen sclerosus (LS).
  
  
  METHODS
  A total of 32 men with LS underwent BMG urethroplasty from January 2010 to September 2012. In 27 patients, stricture was limited to the penile urethra, while in five patients, both bulbar and penile urethra were involved. In these five patients, the entire anterior urethra was replaced with BMG. In nine (28.1%) younger patients (mean age 38.2 years, range 33-45), with adverse local conditions and significant scarring, two-stage repair was done. The paired t test was performed on preoperative and postoperative Qmax as well as on preoperative and postoperative post-void residual urine volume, and the Fisher exact test was used to assess success between treatment groups. The chi-squared test was used to compare categorical data.
  
  
  RESULTS
  The overall success rate was 90.6%. Complications occurred in 9.4% of the patients (3 of 32) including hematoma in two patients and fistula in one patient. In this cohort of patients, mean preoperative Qmax was 6.2 ml per second (range 2.6-10.2) versus 18.2 (range 15.8-21.2) postoperatively (at 9 months), which was statistically significant (p < 0.002). Also, mean preoperative post-void residual urine volume was 110 ml (range 75-180) versus 19 ml (range 10-40) postoperatively at 9 months, which was statistically significant (p < 0.004).
  
  
  CONCLUSIONS
  Buccal mucosa is the most reliable graft for repairing anterior urethral strictures in patients with LS. Minimal complications are observed, even in cases of long stenosis completely afflicting anterior urethra.
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia. drmiodragacimovic@gmail.com.
authors.forename: Miodrag
authors.initials: M
authors.lastname: Acimovic
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia.
authors.forename: Bogomir
authors.initials: B
authors.lastname: Milojevic
authors.affiliation: General Hospital Bel Medic, Belgrade, Serbia.
authors.forename: Marko
authors.initials: M
authors.lastname: Milosavljevic
authors.affiliation: Department of Urology, University Hospital of Bialystok, Białystok, Poland.
authors.forename: Marta
authors.initials: M
authors.lastname: Skrodzka
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Radovanovic
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia.
authors.forename: Dragutin
authors.initials: D
authors.lastname: Rafailovic
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, School of Medicine, University of Belgrade, Resavska 51, Belgrade, 11000, Serbia.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Dzamic
authors.affiliation: Serbian Academy of Sciences and Arts, Belgrade, Serbia.
authors.forename: Jovan Hadzi
authors.initials: JH
authors.lastname: Djokic
authors.affiliation: Sava Perovic Foundation (RD), Belgrade, Serbia.
authors.forename: Rados
authors.initials: R
authors.lastname: Djinovic
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*
keywords: Anterior urethral strictures; Buccal mucosa graft; Complications; Lichen sclerosus; Urethroplasty