Two-Staged Urethroplasty: Buccal Mucosa and Mesh Graft Techniques

 

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Abstract

Purpose: The purpose of this study was to describe indications, the operative technique and results of the two-staged buccal mucosa (BM) and mesh graft urethroplasty for treatment of ­urethral strictures. Material and Methods: Between 3 / 1993 and 12 / 1999, urethral reconstructions were performed in 267 consecutive patients (group I), including 68 mesh graft urethroplasties (25 %) and 30 BM urethroplasties (12 %). Between 1 / 2000 and 8 / 2004, additional 249 urethroplasties were performed: Of those, 12 % were mesh graft and 50 % BM urethroplasties (group II). Results: In patient group I, stricture recurrence was found to be the main complication of both procedures (BM 17 %, mesh 16 %). However, erectile dysfunction and curvature only occurred in the mesh graft group with 4 % and 9 %, respectively. Patient satisfaction was high in both groups (BM 96.7 %, mesh 83.3 %). Between 1 / 2000 and 8 / 2004 (group II) the number of BM urethroplasties increased to 50 %, whereas the number of mesh graft urethroplasty decreased (12 %). More than 80 % of the patients were satisfied with the results. Conclusions: Long strictures with severe spongiofibrosis represent an indication for two staged urethro­plasty (BM and mesh graft). Excellent ­results can be achieved with both techniques with a similar rate of complications. The mesh graft technique remains the last option for a complex patient group.

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Dr. D. Pfalzgraf

Universitätsklinikum Hamburg Eppendorf

Martinistr. 52

20246 Hamburg

Email: dpfalzgr@uke.uni-hamburg.de