Experience with one-stage buccal mucosa graft urethroplasty

70 Experience with one-stage buccal mucosa graft urethroplasty Murányi M.1, Benyó M.1, Kiss Z.1, Redl P.2, Szabó A.2, Flaskó T.1 1 University of Debrecen, Dept. of Urology, Debrecen, Hungary, 2University of Debrecen, Dept. of Oral and Maxillofacial Surgery, Debrecen, Hungary INTRODUCTION & OBJECTIVES: Some decades ago urethral reconstruction was a considerably separate field of urology. Complex urethroplasties with skin flaps were performed by specialists in few centers. Urethroplasty became simpler and more reproducible due to the advent of novel surgical techniques applying buccal mucosa graft. We present our experience with one-stage buccal mucosa graft urethroplasty performed without former experiences in urethral reconstruction. MATERIAL & METHODS: 15 buccal urethroplasties were performed in cooperation with oral surgeons. The average age of the patients was 56.2 (21-79) years. Urethral strictures developed after transurethral resections of the prostate in 8 cases, after traumatic perioperative catheterisation in 3 cases, after long term indwelling catheterisation in 2 cases, after urethral trauma due to pelvic fracture in 1 case and after urethritis in 1 case. 11 patients had bulbar and 4 had pendular urethral stricture. RESULTS: Buccal grafts were harvested by an oral surgeon. Ventral onlay, dorsal inlay, dorsal onlay and lateral onlay technique were applied in 9, 3, 2 and 1 cases, respectively. According to the ClavienDindo classification system one stage I and one stage II complications occurred in the postoperative period: 1 wound infection requiring local conservative treatment and 1 acute epididymitis treated by antibiotics. Patients were discharged from the hospital 7.0 (4-11) days after surgery. Catheters were removed 31.5 (20-47) days after surgery. Rejection of the graft or urethrocutaneous fistula was not observed. Recurrent stricture requiring repeated intervention did not occur during an average of 1.1year follow-up period. The mean postoperative maximum flow rate was 22.3 (7-38) mL/sec. 4 of 15 patients micturited with a maximum flow of under 15 mL/sec. CONCLUSIONS: Buccal mucosa graft urethroplasty has revolutionized the treatment of urethral stricture. Application of penile skin flaps can be avoided with the aid of this technique, thus penile anatomy can be preserved resulting in a better cosmetic result. Our experience reveals good reproducibility of buccal mucosa urethroplasty and emphasizes the role of the good multidisciplinary cooperation. Eur Urol Suppl 2015; 14(6): e1237