The aim of this study is to analyze the outcomes of dorsal onlay buccal mucosal graft (BMG) and penile skin graft (PSG) urethroplasty in the management of long segment bulbar urethral stricture.
Penile urethral reconstruction proves to be a continuous challenge as no perfect technique is considered for all patients with this problem. Among all the methods used for treatment of urethral stricture, the substitution urethroplasty with tissue transfer using either flap or graft is the gold standard treatment option for long segment urethral strictures. In 1993, McAninch described a circular fasciocutaneous flap for the management of penile urethral stricture up to 15 cm that showed excellent cosmetic and functional outcomes due to this being a hairless, flexible flap with a rich vascular supply. Buccal mucosal graft (BMG) was rediscovered and popularized in 1992 by Burger et al., then El-Kassaby et al. in 1993 published a series using buccal mucosal graft to repair anterior urethral stricture. Buccal mucosal graft became an ideal urethral substitute due to easy harvesting, hairlessness and compatibility in a wet environment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
Urethroplasty using a buccal mucosal graft harvested from the inner cheek. The graft is dorsally onlaid to reconstruct the strictured urethral segment. The procedure is conducted under spinal or general anesthesia.
Urethroplasty using a penile skin graft harvested from the ventral surface of the penis. The graft is applied dorsally after excision of the fibrotic urethral segment. The surgery is performed under spinal or general anesthesia.
Tanta University
Tanta, El-Gharbia Governorate, Egypt, Egypt
RECRUITINGSurgical Success Rate
Success is defined as satisfactory urinary stream with no need for further intervention (such as dilatation or DVIU) and no evidence of stricture on retrograde urethrogram during follow-up.
Time frame: 9 months postoperatively
International Prostate Symptom Score (IPSS)
Evaluation of changes in urinary symptoms using International Prostate Symptom Score (IPSS) to assess functional outcome and patient comfort after urethroplasty will be assessed.
Time frame: 9 months postoperatively
Length of Urethral Stricture
Length of Urethral Stricture will be measured to compare the characteristics of strictures managed by each graft technique.
Time frame: Intraoperatively
Postoperative Complications
Complications such as infection, bleeding, graft failure, and fistula formation following surgery will be recorded.
Time frame: 9 months postoperatively
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