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  Global Journal of Surgery. Volume 1, Issue 2 (2010) pp. 134-138
  Research Article
Our experience with dorsolateral onlay urethroplasty for anterior urethral strictures by a unilateral urethral mobilization approach
  Rajendra B Nerli*, Ashish C Koura, Shivagouda Patil, Ajaykumar Guntaka, Murigendra B Hiremath  
Department of Urology, KLE University’s JN Medical College and KLES Kidney Foundation, Belgaum, India
  Introduction: Buccal mucosal graft substitution urethroplasty has become popular in the management of intractable anterior urethral strictures with good results. Excellent long term results have been reported by both dorsal and ventral onlay techniques. Conventional dorsal onlay urethroplasty requires circumferential mobilization of the urethra, which might cause ischemia of the urethra in addition to chordee. We took up this prospective study to determine the feasibility of performing a dorsolateral free buccal mucosal graft urethroplasty to treat anterior urethral strictures by unilateral urethral mobilization and note the outcome. Experimental: During the period Jan 2003 to Dec 2008, patients with strictures of the anterior urethra were treated by a dorsolateral free buccal mucosal graft. The urethra was accessed either through the perineal incision or by degloving of penis or a combination of both these routes. The urethra was separated from the corporal bodies on one side only. The urethra was opened in the dorsal midline over the stricture. The buccal mucosal graft was secured on the ventral tunica of the corporal bodies. Results and Discussion: During the study period 23 patients,18 – 48 years old twenty three patients underwent the procedure. The mean preoperative Q max was 7.2 ml/sec and the mean postoperative Q max was 16.95 ml/sec. After a mean follow-up of 38.8 months, two recurrences were noted, both needing internal urethrotomy. Conclusions: An unilateral mobilization of the anterior urethra is feasible to apply a dorsolateral free buccal mucosal graft of any length and treat strictures with good short and medium term success.
  Urethra; Anterior urethral stricture; Urethroplasty; Buccal mucosal graft  

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