Oral mucosal grafts in one-stage urethroplasty for panurethral strictures

• Main Author: Ngwobia Peter Agwu, Ismaila Arzika Mungadi
• Format: Article
• Language: English
• Published: Bulgarian Association of Young Surgeons 2020-04-01
• Series: International Journal of Surgery and Medicine
• Subjects: panurethral strictures; oral mucosa grafts
• Online Access: http://www.ejos.org/index.php?fulltxt=77922&fulltxtj=136&fulltxtp=136-1576253234.pdf

Objectives: Panurethral strictures are complex and extensive strictures that involve the penile and bulbar urethra. Management of these patients is challenging. In the last two decades, oral mucosal grafts have gained widespread popularity as the most versatile substitute tissue for urethral reconstruction. This paper presents the short- term outcome of our experience in the use of oral mucosal grafts in one-stage urethroplasty in patients with panurethral strictures. Patients and Methods: Between April 2012 and January 2017, 62 men were evaluated and had one-stage oral mucosa urethroplasty for panurethral strictures. Results: The mean age of the patients was 50 years with a range of 11-75 years. Aetiological factors were poorly treated urethritis 39 (62.9%), indwelling urethral catheterization 18 (29.0%), trauma 1 (1.6%) and lichen sclerosis 1 (1.6%). Reasons for urethral catheterization were for intraoperative monitoring 9 (50.0 %), relief of acute urine retention 4 (22.2%) and others 4 (22.2%). Fifty-two patients (83.9%) had preliminary urinary diversion by supra-pubic cystostomy before urethroplasty. The mean OMG length was 11.7cm and donor sites were buccal in 37 (59.7%), combined buccal and labial in 20 (32.3%). Fifty-seven (88.7%) patients had satisfactory voiding on removal of the urethral catheter. Donor site complications were reactionary haemorrhage 1 patient, stay suture lip injury 1, pain and numbness in 6 (9.6%) patients. Superficial wound infections were recorded in 6(9.7%) patients. The duration of follow-up ranged from 1-29 months; mean 6 months. There was no mortality. Conclusion: Panurethral strictures are common in our practice mainly resulting as complication of poorly treated urethritis and urethral catheterization. Urethral reconstruction by one-stage oral mucosa graft urethroplasty is feasible, has good, short-term outcome though it may be associated with minor donor site complications. Larger number of patients and longer- term follow up are needed to assess the durability of the procedure.