Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures
The treatment of long urethral strictures is based on the use of buccal mucosa graft (BMG). Postoperative failures commonly occur in patients with the obliterative strictures, and the long augmented part of the urethra which is prone to fibrotic changes. Combined approach with the resection of the o...
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Sociedade Brasileira de Urologia
2015-12-01
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Series: | International Brazilian Journal of Urology |
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doaj-80c18879645f462f82b96acd98a2be342020-11-24T20:41:40ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192015-12-014161234123510.1590/S1677-5538.IBJU.2015.0065S1677-55382015000601234Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral StricturesIvan IgnjatovicMilan PoticDragoslav BasicLjubomir DinicDarko LaketicMarija MihajlovicAleksandar SkakicThe treatment of long urethral strictures is based on the use of buccal mucosa graft (BMG). Postoperative failures commonly occur in patients with the obliterative strictures, and the long augmented part of the urethra which is prone to fibrotic changes. Combined approach with the resection of the obliterative part of the urethral plate located in the bulbar urethra, together with the ventral placement of BMG was performed in 36 patients. Etiology of the stricture was: idiopathic in 19/36 (52.7%), iatrogenic in 14/36 (38.8%), and other causes in 3/36 (8.3%). Mean length of the stricture was 7.2±1.6 cm, and the length of the augmented graft 4.5±1.2 cm (due to resected urethral plate) so, the single BMG was enough in 25/36 (69.4%) patients. The medium postoperative follow up was 24 months (20–28 months) months. Success of the surgery was defined as no need for additional surgery neither dilatation. Cystoscopy was performed 4–6 months after the surgery and additional follow up with IPSS and uroflowmetry. Overall success was achieved in 31/36 (86.1%) patients. Mean postoperative IPSS was 9.5±2.1 in these patients. Complications were according to Clavien Dindo scale: grade II in 11/36 (30.5%-infection, orchialgia, scrotal pain), grade III in 4/36 (11.1%-fistula) and grade IV in 5/36 (14.5% - restenosis). Postoperative Qmax= 13.2±1.2 ml/s. Bell shaped curve was present in 14/36(38.8%). Our results suggest that overall success rate is similar to the expected values for BMG surgery, and the number of the grafts used is lower due to reduced stricture length.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382015000601234&lng=en&tlng=en |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ivan Ignjatovic Milan Potic Dragoslav Basic Ljubomir Dinic Darko Laketic Marija Mihajlovic Aleksandar Skakic |
spellingShingle |
Ivan Ignjatovic Milan Potic Dragoslav Basic Ljubomir Dinic Darko Laketic Marija Mihajlovic Aleksandar Skakic Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures International Brazilian Journal of Urology |
author_facet |
Ivan Ignjatovic Milan Potic Dragoslav Basic Ljubomir Dinic Darko Laketic Marija Mihajlovic Aleksandar Skakic |
author_sort |
Ivan Ignjatovic |
title |
Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures |
title_short |
Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures |
title_full |
Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures |
title_fullStr |
Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures |
title_full_unstemmed |
Resection of the Urethral Plate and Augmented Ventral Buccal Graft in Patients with Long Obliterative Urethral Strictures |
title_sort |
resection of the urethral plate and augmented ventral buccal graft in patients with long obliterative urethral strictures |
publisher |
Sociedade Brasileira de Urologia |
series |
International Brazilian Journal of Urology |
issn |
1677-6119 |
publishDate |
2015-12-01 |
description |
The treatment of long urethral strictures is based on the use of buccal mucosa graft (BMG). Postoperative failures commonly occur in patients with the obliterative strictures, and the long augmented part of the urethra which is prone to fibrotic changes. Combined approach with the resection of the obliterative part of the urethral plate located in the bulbar urethra, together with the ventral placement of BMG was performed in 36 patients. Etiology of the stricture was: idiopathic in 19/36 (52.7%), iatrogenic in 14/36 (38.8%), and other causes in 3/36 (8.3%). Mean length of the stricture was 7.2±1.6 cm, and the length of the augmented graft 4.5±1.2 cm (due to resected urethral plate) so, the single BMG was enough in 25/36 (69.4%) patients. The medium postoperative follow up was 24 months (20–28 months) months. Success of the surgery was defined as no need for additional surgery neither dilatation. Cystoscopy was performed 4–6 months after the surgery and additional follow up with IPSS and uroflowmetry. Overall success was achieved in 31/36 (86.1%) patients. Mean postoperative IPSS was 9.5±2.1 in these patients. Complications were according to Clavien Dindo scale: grade II in 11/36 (30.5%-infection, orchialgia, scrotal pain), grade III in 4/36 (11.1%-fistula) and grade IV in 5/36 (14.5% - restenosis). Postoperative Qmax= 13.2±1.2 ml/s. Bell shaped curve was present in 14/36(38.8%). Our results suggest that overall success rate is similar to the expected values for BMG surgery, and the number of the grafts used is lower due to reduced stricture length. |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382015000601234&lng=en&tlng=en |
work_keys_str_mv |
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