Acellular Tissue Engineered Pericardial Patch Urethroplasty: A New Horizon of Substitution Urethroplasty

OBJECTIVE: Buccal mucosal graft is the best autologous material for substitution urethroplasty. However, in cases where buccal mucosa is unavailable, a non-autologous tissue like acellular tissue-engineered pericardial patch can be very helpful. Our study is a small approach regarding the success and durability of acellular tissue-engineered pericardial patch as a substitution tissue in urethroplasty. MATERIAL AND METHODS: A total of 22 patients underwent acellular tissue-engineered pericardial patch substitution urethroplasty using dorsolateral onlay technique for long segment urethral stricture, for a period of two years. Observations and comparison were made in terms of postoperative change in maximum urinary flow rate (Q(max)), resolution of obstructive lower urinary tract symptoms, improvement in retrograde urethrogram and complications encountered, with buccal mucosal graft urethroplasty as a historical control. RESULTS: Out of these 22 patients, 18 patients had successful outcomes considering maximum flow rate (Q(max)) > 10 mL/s on uroflowmetry, resolved obstructive lower urinary tract symptoms, and normal postoperative retrograde urethrogram, whereas four patients were considered a failure because of Q(max) <10 mL/s, unresolved obstructed lower urinary tract symptoms and recurrence of urethral stricture on retrograde urethrogram and development of urethrocutaneous fistula. CONCLUSION: Acellular tissue-engineered pericardial patch substitution urethroplasty can be a useful alternative to autologous tissue substitution, especially where the buccal mucosal graft is unavailable for urethroplasty.