Title: Ventral Onlay Buccal Mucosal Graft Urethroplasty Based on Tunica Vaginalis Flap for Balanitis Xerotica Obliterans Related Urethral Strictures: The Outcome of Single- Stage Reconstruction
Authors: Shanky Singh, Vaibhav Vikas, Priyabarta Das, Jatin Soni
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.15
Abstract
Background: Balanitis xerotica obliterans (BXO) related urethral strictures treatment demand particular attention to cosmesis and urethral patency. Usually a single or two- stage urethroplasty is needed in such cases. We assessed the feasibility and efficacy of single-stage ventral onlay buccal mucosal urethroplasty (VOBMGU) based on tunica vaginalis flap for such strictures.
Materials and Methods: In between January 2015 and April 2017, ten patients with BXO related anterior urethral strictures underwent VOBMGU based on tunica vaginalis flap in single stage. Three patients presented with a suprapubic catheter. Assessment of stricture was done using a retrograde urethrogram and micturating cystourethrogram. All patients had meatal stenosis with anterior urethral stricture. Treatment outcome was assessed in terms of cosmetic appearance, stricture recurrence and complications.
Results: At a mean follow-up of 20 months, 8 were free of stricture recurrence as assessed by uroflowmetry and cystoscopy. Two had recurrent stricture which was treated successfully with direct visual internal urethrotomy. All patients had a normal slit-like meatus; none had chordee or erectile dysfunction. Complications were self-limited.
Conclusion: In BXO related strictures with a viable urethral plate, ventral onlay buccal mucosal urethroplasty (VOBMGU) based on tunica vaginalis flap provides excellent results as a single-stage reconstruction procedure, with tunica vaginalis as a readily available tissue having several advantages, including close proximity to the penis, ease of use, high vascularity and providing good support to BMG graft.
Keywords: Balanitis xerotica obliterans, Buccal mucosa graft, Ventral onlay, Tunica vaginalis.
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