Balasubramaniam, R (2010) Role of buccal mucosal graft substation urethroplasty in stricture urethra. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : The long term effects of internal urethrotomies are poor either requiring repeated dilatation or repeated urethrotomies. Conventional urethroplasty including end to end urethroplasty produce consistent result. The use of grafts or flaps is mandatory in patients with longer and complex strictures. On lay graft is the recent addition to the armamentarium. On lay graft is done either dorsally or ventrally. Various tissues like penile skin, posterior auricular skin, bladder mucosa or buccal mucosa are used. Since 1995 _96 Barbagli described a new dorsal on lay urethroplasty, it has been greeted with fair amount of enthusiasm throughout the world. Success rate of the procedure has been 92 – 95 % for a period of 19 to 36 months. We have attempted to extend the use of the procedure for long anterior urethral strictures including pan urethral strictures using buccal mucosal graft. AIM : To evaluate the efficacy of dorsal on lay buccal mucosal graft urethroplasty in treating long anterior urethral strictures. MATERIALS AND METHODS : It is a prospective study from August 2007 to May 2010. A total of 34 patients were enrolled in the study. Inclusion Criteria: 1. Strictures > 2.5cm in length 2. Patients requiring repeated internal urethrotomy or dilatations. Exclusion Criteria: 1. Periurethral phlegmon, 2. Multiple urethrocutaneous fistula, 3. Associated with chronic renal failure, 4. Scarred perineum. The preoperative workup included careful general physical examination, palpation of the anterior urethra for any mass; glans penis inspected for signs of urethral meatal stenosis or balanitis xerotica obliterans. The perineum was inspected and examined for the presence of fistulas or periurethral inflammation. Dental surgeon’s opinion was obtained regarding the hygiene of the oral cavity and to rule out any buccal mucosal pathology. CONCLUSION : Buccal mucosal graft has good graft properties for graft survival with minimal donor site morbidity. Dorsal onlay graft is the preferred form of graft placement. Buccal mucosal graft is an ideal substitute for urethra in treating medium length bulbar urethral stricture. Because of less failure rate 20% it can be offered as an alternative to staged urethroplasty in case of long urethral stricture.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | buccal mucosal graft substation urethroplasty ; stricture urethra. |
| Subjects: | MEDICAL > Urology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 10 Aug 2017 01:56 |
| Last Modified: | 10 Aug 2017 01:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2538 |
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