BUCCAL MUCOSAL URETHROPLASTY FOR BALANITIS XEROTICA OBLITERANS RELATED URETHRAL STRICTURES: THE OUTCOME OF 1 AND 2-STAGE TECHNIQUES
Adult
Male
Urethral Stricture
Urologic Surgical Procedures, Male
Adolescent
Mouth Mucosa
Middle Aged
3. Good health
03 medical and health sciences
Treatment Outcome
0302 clinical medicine
Urethra
Balanitis
Humans
Child
DOI:
10.1097/01.ju.0000149740.02408.19
Publication Date:
2005-01-07T16:16:32Z
AUTHORS (6)
ABSTRACT
Balanitis xerotica obliterans (BXO) related strictures are complex and generally managed by 2-staged urethroplasty. We present our results with 1-stage dorsal onlay and 2-stage buccal mucosal urethroplasty for such strictures.Between January 2000 and April 2004, 39 patients underwent buccal mucosal urethroplasty for BXO related anterior urethral strictures. The 25 patients with a salvageable urethral plate (group 1) were treated with 1-stage dorsal onlay urethroplasty using a cosmetic incision. The 14 patients with a severely scarred urethral plate, focally dense segments or active infection (group 2) underwent 2-stage urethroplasty. Outcomes in terms of cosmetic appearance, stricture recurrence and complications in the 2 groups were assessed.At a mean followup of 32.5 months (range 3 to 52) 3 patients (12%) in group 1 had recurrent stricture, of which 2 and 1 were treated with optical urethrotomy and urethral dilation, respectively. All patients had a normal slit-like meatus and none had chordee or erectile dysfunction. Four group 2 patients (28.6%) required stomal revision and 2 had glans cleft narrowing after stage 1 urethroplasty. Following stage 2, 3 patients had recurrent stricture, of whom 2 were treated with optical urethrotomy and 1 underwent repeat urethroplasty.In BXO related strictures with a viable urethral plate 1-stage dorsal onlay buccal mucosal urethroplasty provides excellent intermediate term results. The cosmetic incision described provides a normal, wide caliber, slit-like glans. Two-stage procedures provide satisfactory outcomes but they are associated with a higher revision rate.
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