Dergiler / Turkish Journal of Urology / 2017 / Cilt: 43 - Sayı: 3

Does site of buccal mucosa graft for bulbar urethra stricture affect outcome? A comparative analysis of ventral, dorso-lateral and dorsal buccal mucosa graft augmentation urethroplasty

Bulber üretra darlığı için bukkal mukoza greftinin alınma yeri sonucu etkiler mi? Ventral, dorsolateral ve dorsal bukkal mukoza greftiyle gerçekleştirilen ogmentasyon üretroplastilerinin karşılaştırmalı analizi

Sayfa
350–354
DOI
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Patients with extensive spongiofibrosis and long segmentstrictures had higher rates of failure.

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Amaç & Hipotez:Objective: To compare long- term outcomes of buccal mucosa graft (BMG) augmentation urethroplasty forlong segment bulbar urethral strictures done by placing the graft ventrally, dorso-laterally and dorsally.Material and methods: We conducted a single institution retrospective study on 112 who underwent BMG augmentationurethroplasty for non-traumatic bulbar urethral strictures between January 2005 to December 2014.The cases were divided into three groups based on the site of placement of BMG graft i.e. (a) Ventral (n=44), (b)Dorso-lateral (n=48) and (c) Dorsal (n=20).
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Temel Bulgular & Veri:Patients with failedoutcomes underwent urethroscopy or retrograde urethrogram to note the site of recurrence of stricture.Results: Out of 112 cases 91 (81%) were successful and 21 (19%) failed.
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Sonuç & Katkı:Patients with extensive spongiofibrosis and long segmentstrictures had higher rates of failure.
🔬Tür:Araştırma Makalesi
📍Kapsam:2005 Verileri
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: To compare long- term outcomes of buccal mucosa graft (BMG) augmentation urethroplasty forlong segment bulbar urethral strictures done by placing the graft ventrally, dorso-laterally and dorsally.Material and methods: We conducted a single institution retrospective study on 112 who underwent BMG augmentationurethroplasty for non-traumatic bulbar urethral strictures between January 2005 to December 2014.The cases were divided into three groups based on the site of placement of BMG graft i.e. (a) Ventral (n=44), (b)Dorso-lateral (n=48) and (c) Dorsal (n=20). Follow-up period was from one year to five years. Patients with failedoutcomes underwent urethroscopy or retrograde urethrogram to note the site of recurrence of stricture.Results: Out of 112 cases 91 (81%) were successful and 21 (19%) failed. The success rates for ventral, dorsolateraland dorsal BMG augmentation procedures were 89%, 79% and 70%, respectively (p=0.18). Among21 failed cases, 12 cases (57%) had stricture at proximal anastomotic site, 4 cases (19%) at graft and 5 cases(24%) at distal anastomotic site (p=0.01).Conclusion: The overall success rate for BMG augmentation urethroplasty is equal for all techniques. Ventralonlay urethroplasty provides better exposure of proximal anastomotic site thus it is associated withminimum proximal anastomotic site recurrence rates. Patients with extensive spongiofibrosis and long segmentstrictures had higher rates of failure.

Abstract

Amaç: Uzun segmentli bulber üretra darlıklarında, ventral, dorsolateral ve dorsal yerleşimli greftle uygulanan bukkal mukoa greft (BMG) ogmentasyon üretroplastisinin uzun dönemli sonuçlarını karşılaştırmak Gereç ve yöntemler: Travmatik nedenlere bağlı olmayan bulber üretra darlıklı 112 olguda 2005-2014 arasında uyguladığımız BMG ogmentasyon üretroplastilerinin retrospektif tek merkezli çalışmasını gerçekleştirdik. BMG greftinin yerleştirilme bölgesine göre olgular üç gruba ayrılmıştır.(a) ventral (n=44), (b) dorsolateral (n=48) ve (c) dorsal (n=20). İzlem süresi bir yılla beş yıl arasında değişmekteydi. Başarısız olunan hastalara darlığın nüks ettiği yeri saptamak için üretroskopi veya retrograt üretrogram uygulandı. Bulgular: Yüz on iki olgununn 91’inde (%81) başarılı ve 21’inde (%19) başarısız olunmuştur. Ventral, dorsolateral ve dorsal BMG ogmentasyonunda başarı oranları sırasıyla %89, %79 ve %70 idi (p=0,18). Başarısız olunan 21 olgudan 12’sinde (%57) proksimal anastomoz yerinde darlık, 4 (%19) pan greft ve 5 (%24) distal anastomoz yerinde darlık (p=0,01) vardı. Sonuç: BMG ogmentasyon üretroplastisinde genel başarı oranı tüm teknikler için benzerdi. Ventral onlay üretroplastisi proksimal anastomoz yerinin daha iyi açılımını sağladığından proksimal anastomoz yerinde nüks oranı minimal düzeydedir. Yaygın sponjiyofibrozu ve uzun segment darlıkları olan hastalarda başarısızlık olasılığı daha yüksekti.

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Bu Makaleye Atıf Yap

PATHAK, H. R., JAİN, T. P., BHUJBAL, S. A., MESHRAM, K. R., GADEKAR, C., PARAB, S. (2017). Does site of buccal mucosa graft for bulbar urethra stricture affect outcome? A comparative analysis of ventral, dorso-lateral and dorsal buccal mucosa graft augmentation urethroplasty. Turkish Journal of Urology, Cilt: 43 - Sayı: 3, 350–354. https://ajindex.com/articles/380017

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Kaynakça (4)

  1. Singh BP, Pathak HR, Andankar MG. Dorsolateral onlay urethroplasty for anterior urethral strictures by a unilateral urethral mobilization approach. Indian J Urol 2009;25:211-4. [Crossref] Vasudeva P, Nanda B, Kumar A, Kumar N, Singh H, Kumar R. Dorsal versus ventral onlay buccal mucosal graft urethroplasty for long-segment bulbar urethral stricture: A prospective randomized study. Int J Urol 2015;22:967-71. [Crossref] Wang K, Miao X, Wang L, Li H. Dorsal onlay versus ventral onlay urethroplasty for anterior urethral stricture: a meta-analysis. Urol Int 2009;83:342-8. [Crossref] Hosseini J, Kaviani A, Hosseini M, Mazloomfard MM, Razi A. Dorsal versus ventral oral mucosal graft urethroplasty. Urol J 2011;8:48-53.
  2. Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique? J Urol 2005;174:955-8. Naudé AM, Heyns CF. What is the place of internal urethrotomy in the treatment of urethral stricture disease? Nat Clin Pract Urol 2005;2:538-45.
  3. Wong SS, Narahari R, O’Riordan A, Pickard R. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men. Cochrane Database of Systematic Reviews 2010: CD006934. Steenkamp JW, Heyns CF, de Kock ML. Internal urethrotomy versus dilation as treatment for male urethral strictures: a prospective, randomized comparison. J Urol 1997;157:98-101. [Crossref] Heyns CF, Steenkamp JW, De Kock ML, Whitaker P. Treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful? J Urol 1998;160:356-8.
  4. Stein DM, Thum DJ, Barbagli G, Kulkarni S, Sansalone S, Pardeshi A, et al. A geographic analysis of male urethral stricture aetiology and location. BJU Int 2013;112:830-4. [Crossref] Palminteri E, Berdondini E, Verze P, De Nunzio C, Vitarelli A, Carmignani L. Contemporary urethral stricture characteristics in the developed world. Urology 2013;81:191-6. [Crossref] Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol 2007;177:1667-74. [Crossref] Lacy JM, Cavallini M, Bylund JR, Strup SE, Preston DM. Trends in the management of male urethral stricture disease in the veteran population. Urology 2014;84:1506-9. [Crossref]