96 Buccal mucosa substitution urethroplasty experience

Introduction: Buccal Mucosa is the free graft of choice in substitution urethroplasty. I have reviewed a consecutive series of patients undergoing a buccal mucosa urethroplasty to determine outcomes and complications. Method: A retrospective review of all patients who underwent a buccal mucosa graft for their substitution urethroplasty was undertaken. Follow-up was for a minimum of 6 months and included symptom review and a urethrogram at 3 months with a further review at 6 months and urethrogram as required. Results: Thirty-three patients were followed with a mean follow-up of 36 months (range 6 – 72 months). Age range 6 to 79 years. 19 patients underwent a bulbar urethroplasty (10 ventral patch) with 1 stricture recurrence. 13 patients underwent a 2 stage repair with 3 requiring revisions before their 2nd stage due to graft shrinkage. 11 of 13 have had a successful 2nd stage, 2 awaiting repair. One complete tube graft failed. Of the 33 donor sites, 19 were primarily closed and three developed contractures requiring operative correction. Primary closures were more painful. Conclusion: This retrospective review confirms the success of buccal mucosal graft as successful for substitution urethroplasty. Significant graft shrinkage occurs in staged repairs, dissection and graft size needs to accommodate this. Donor graft sites should be left open.