Comparative analysis of one- and two-stage augmentation urethroplasty with dorsal INLAY buccal graft for extended stricturesof spongious urethra


DOI: https://dx.doi.org/10.18565/urology.2018.1.84-90

M.I. Kogan, V.P. Glukhov, V.V. Mitusov, V.V. Krasulin, A.V. Il’yash

Rostov State Medical University of Minzdrav of Russia, Rostov on Don, Russia
Introduction. Urethral reconstructive surgery is in constant development. At present, reconstructive urethroplasty with buccal mucosa is increasingly being used. The study aimed to compare the results of a one- and two-stage augmentation urethroplasty with dorsal inlay buccal graft for strictures of the spongious urethra.
Materials and methods. The study comprised 72 patients aged 19-64 with urethral strictures 3-18 cm long. In 34 (47.2%) patients, the stricture was localized in the penile urethra, in 30 patients (41.6%) in the penile-bulbous urethra and in 8 patients (11%) in the bulbous urethra. All patients underwent augmentation urethroplasty with dorsal inlay buccal graft. The results were evaluated separately in 55 (76.4%, group 1) and 17 (23.6%, group 2) patients who underwent one-stage and two-stage surgery, respectively.
Results. The incidence rate of early postoperative complications was higher after one-stage (23.6%) compared two-stage surgery (11.8%) (p<0.05). Hematomas, wound dehiscence and urethrocutaneous fistulas were observed only after single-stage surgery. Primary healing of extensive strictures following augmentation urethroplasty with dorsal inlay buccal graft was achieved in 88.9% of patients; treatment effectiveness in the group 1 was 89.1%, in the group 2 – 88.2% (p>0.05). The final effectiveness of the operation, achieved with the use of additional surgical interventions, is estimated at 98.6%.
Conclusion. The results of augmentation urethroplasty with dorsal inlay buccal graft do not depend on the number of stages, but fewer complications accompany two-stage surgery.
Keywords: urethra, urethral stricture, oral mucosa, graft, augmentation urethroplasty, ventral sagittal urethrotomy, dorsal urethral augmentation

About the Autors


Corresponding author: M.I. Kogan – Dr.Med.Sci., Prof., Head of the Department of Urology and Human Reproductive Health with the Course of Pediatric Urology-Andrology, Faculty of AT and PRS, RostSMU of Minzdrav of Russia, Rostov on Don, Russia; е-mail: dept_kogan@mail.ru


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