Buccal mucosal graft urethroplasty in the treatment of urethral strictures: a prospective study

Chetan Baragi, Raveendra Totad, Shankarsnehit Patil, Nandini Takkalaki


Background: Anterior urethral strictures develop due to a process of fibrosis and cicatrix formation of the urethral mucosa and the surrounding tissues. Its surgical management is a challenging problem, and has changed dramatically in the past several decades. Open surgical repair using grafts has become the gold standard procedure for anterior urethral strictures that are not amenable to excision and primary anastomosis. Oral mucosa harvested from the inner cheek (buccal mucosa) is an ideal material, and is most commonly used for substitution urethroplasty. Objective of current study was to establish the efficacy of the buccal mucosal graft urethroplasty by different onlay techniques in anterior urethral strictures.

Methods: The study was a prospective study, done between August 2009 and December 2011. 25 cases of long anterior urethral strictures were managed by onlay urethroplasty by different techniques. Follow up ranged from 8-20 months.

Results: 3 patients lost follow up after first visit. Post operative uroflowmetry was done in all patients after 1 month at the time of first follow up visit. Of 25 cases 21 (84%) were successful and 4 (16%) failed.

Conclusions: In our study we have found that buccal mucosal graft can be safely used for substitution urethroplasty in all long anterior urethral strictures including cases with balanitis xerotic obliterance. It was very efficient in terms of less graft shrinkage or contracture as it is a full thickness graft.


Urethral stricture, Onlay technique, Buccal mucosa

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