Tunica albuginea versus buccal mucosa graft urethroplasty for anterior urethral stricture: A prospective randomised pilot study

doi:10.1016/j.ajur.2021.12.003

Asian Journal of Urology, 2023, 10 (2): 189-194 doi: 10.1016/j.ajur.2021.12.003

Original Article

Tunica albuginea versus buccal mucosa graft urethroplasty for anterior urethral stricture: A prospective randomised pilot study

Mohammad Shazib Faridi^a,*(

),Vikas Sharma^b,Adittya K. Sharma^c,Rahul Yadav^c

^aDivision of Urology, Department of Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, New Delhi, India
^bDepartment of Urology, Rajiv Gandhi Super Speciality Hospital, Tahirpur, Delhi, India
^cDepartment of Urology, Apollomedics Super Speciality Hospital, Lucknow, Uttar Pradesh, India

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Abstract

Objective: The objective of the study was to compare the outcome of tunica albuginea urethroplasty (TAU) and buccal mucosa graft (BMG) urethroplasty for anterior urethral stricture.
Methods: Thirty patients who met the inclusion criteria were randomised into two groups: TAU (Group A) and BMG urethroplasty (Group B). Surgical outcome was evaluated with pre- and post-operative work-up involving retrograde urethrogram, voiding cystourethrogram, uroflowmetry, and urethroscopy. Patients were followed up till 1 year.
Results: Mean duration of surgery was statistically significant between two groups (p=0.0005). Maximum urine flow rate was comparable when compared between two groups (p=0.22) but statistically significant when compared pre- and post-operatively (p<0.001). At follow-up of 1 year, the successful outcomes were 80% in Group A and 87% in Group B. A total of five patients who had unsuccessful results required redo urethroplasty. Complications were minimal in both the groups.
Conclusion: TAU provides outcomes equivalent to those of BMG urethroplasty. TAU has less operative time, easy to perform, and beneficial in patients with poor oral hygiene.

Key words： Buccal mucosa Male urologic surgery Tunica albuginea Urethral stricture Urethroplasty

Received: 15 October 2020 Available online: 20 April 2023

Corresponding Authors: Mohammad Shazib Faridi E-mail: drshazibfaridi@gmail.com

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Mohammad Shazib Faridi,Vikas Sharma,Adittya K. Sharma, et al. Tunica albuginea versus buccal mucosa graft urethroplasty for anterior urethral stricture: A prospective randomised pilot study[J]. Asian Journal of Urology, 2023, 10(2): 189-194.

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http://www.ajurology.com/EN/10.1016/j.ajur.2021.12.003 OR http://www.ajurology.com/EN/Y2023/V10/I2/189

Flowchart of study design. TAU, tunica albuginea urethroplasty; BMG, buccal mucosal graft.

Intraoperative photograph. (A) Urethra incised dorsally after mobilisation; (B) Urethra stitched to tunica albuginea of corpora cavernosa.

Intraoperative photograph of suturing of buccal mucosal graft margin to urethral margin.

Follow-up protocol. UFM, uroflowmetry; RGU, retrograde urethrogram.

Patient characteristics.

Outcomes of the two procedures.

RGU of a patient. (A) Preoperative; (B) 3 months post tunica albuginea urethroplasty. RGU, retrograde urethrogram. The arrow means bulbar urethral stricture.

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