Substitution Urethroplasty for Anterior Urethral Strictures: Buccal versus Lingual Mucosal Graft

Abstract

Aim: To compare the results of substitution urethroplasty and donor site morbidity between buccal mucosal graft (BMG) and lingual mucosal graft (LMG). Patients and Methods: Patients who underwent single-stage dorsal onlay free oral mucosal graft substitution urethroplasty by Barbagli’s technique between January 2004 and August 2008 were included in this study. Patients who underwent buccal (cheek, lip) mucosal graft urethroplasty were included in group I and those who underwent LMG urethroplasty (tongue) were included in group II. All patients underwent complete evaluation of the stricture including inspection of the oral cavity. Exclusion criteria were stricture length <3 cm and complex strictures which required a multistage procedure. Results: The results of urethroplasty were similar in both groups in terms of blood loss, duration of postoperative hospitalization, complications encountered at urethroplasty site, mean postoperative Q_max and mean postoperative AUA symptom score. Early slurring of speech complications was seen in group II, but not in group I. The long-term complications of persistent oral discomfort, perioral numbness and tightness of the mouth were seen only in group I. Conclusion: LMG urethroplasty is a good substitute for BMG urethroplasty with equally good results of urethroplasty with lower donor site morbidity.

Buccal Versus Lingual Mucosa Graft in Anterior Urethroplasty: A Prospective Comparison of Surgical Outcome and Donor Site Morbidity

“…In this series as well as in other comparative series [12][13][14] , there was no difference in success rate between BMG and LMG. Therefore, LMG appears to be a valuable alternative in case BMG is not possible (e.g.…”

Lingual versus buccal mucosa graft urethroplasty for anterior urethral stricture: A prospective comparative analysis

“…LMG has been proposed as a successful alternative to BMG, with equivalent surgical outcomes and lower graft site mor-bidity. 10,11 Human and animal studies have proven that that uptake of LMG is equivalent to BMG. 14,15 We had chosen to evaluate the morbidity of the graft site in anterior urethral strictures (excluding pananterior Oral mucosa urethroplasty >10 cm), as we found that up to 5 cm (total 10 cm on both sides) of lingual graft could be harvested easily without any significant morbidity.…”

“…Currently BMG urethroplasty is the most common procedure, claimed to be a virtual gold standard for substitution urethroplasty . As a result of known graft site morbidities and instances where one might struggle to find a suitable buccal mucosa graft, there has been recent interest in alternatives, such as LMG, which is shown to have outcomes equivalent to BMG and less morbidity . The present study aimed to compare lingual graft morbidity and urethroplasty outcomes against dorsal onlay BMG urethroplasty, in a randomized prospective study.…”

Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

“…However, buccal mucosa may not be suitable for treating long complicated urethral strictures because of limited material [18]. Lingual mucosal graft urethroplasty is a good substitute for buccal mucosal graft urethroplasty with equally good results of urethroplasty with lower donor-site morbidity [23,24,25,26]. However, it has the same shortcomings as buccal mucosal graft urethroplasty.…”