Repair of panurethral stricture: Proximal ventral and distal dorsal onlay technique of buccal mucosal graft urethroplasty

OBJECTIVE: To report the surgical details and results of our technique of buccal mucosal graft (BMG) urethroplasty for panurethral stricture, as many studies have reported repair of panurethral stricture by single-stage BMG urethroplasty by placing buccal mucosa ventrally, dorsally or dorsolaterally. PATIENTS AND METHODS: This was an observational analysis of 38 patients with panurethral stricture treated by placing two BMGs, one as a ventral onlay in the proximal bulbar urethra and the other as a dorsal onlay in the distal bulbar and penile urethra. Success was defined as asymptomatic state with or without need for a postoperative single intervention such as dilatation or internal urethrotomy. RESULTS: The 38 patients had a mean age of 44 years, with lichen sclerosus as the predominant cause of stricture. The ultimate success rate was 84.2% at the end of 3 months and 89.5% at the end of 1 year. Recurrent strictures appeared only in the failed cases during the follow-up period of 11 months. None of the patients needed redo urethroplasty during the follow-up period. CONCLUSIONS: A proximal ventral and distal dorsal onlay technique of BMG urethroplasty is an available alternative for repairing panurethral stricture. The technique described is simple and easily reproducible with encouraging results compared to other similar techniques.