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Augmented perineal urethrostomy using a dorsal buccal mucosal graft, bi-institutional study

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Abstract

Purpose

To present our technique and outcomes for perineal urethrostomy augmented with a dorsal onlay buccal mucosa graft (BMG). Results from initial series and collaboration from an international center are included.

Methods

A retrospective chart review of all adult patients who underwent urethral reconstruction with perineal urethrostomy utilizing a buccal mucosal graft between January 1, 2002 and January 1, 2013 was performed. All surgeries were performed by three surgeons using the same technique (GHJ, KAM, and RV). Success was defined as no need for additional treatment following definitive surgery.

Results

A total of 44 patients met inclusion criteria. Mean patient age was 60 (range 44–81) years. All strictures were pananterior. Etiologies included unknown in 16 (36%), failed hypospadias repair in six (14%), lichen sclerosus in ten (23%), iatrogenic in seven (16%), Fournier’s in three (7%), urethral cancer in one (2%) and penile cancer in one (2%). Mean follow-up was 45 (range 6–136) months. Overall success was 80%. Nine patients recurred, of which four had a successful revision, two are awaiting potential revision, and three are being managed with periodic dilations.

Conclusions

BMG perineal urethrostomy is a valid alternative for complex urethral strictures due to lichen sclerosus, previous failed reconstructions or hypospadias cripples. Midterm results are encouraging for this novel technique.

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Authors and Affiliations

  1. Department of Urology, Eastern Virginia Medical School (EVMS), Norfolk, VA, USA

    Jessica DeLong, Kurt McCammon, Jeremy B. Tonkin, Gerald Jordan & Ramón Virasoro

  2. Department of Urology, Centro de Educación Medica e Investigaciones Cínicas “Dr. Norberto Quirno” (CEMIC), Buenos Aires, Argentina

    Leandro Capiel, Augustín Rovegno & Ramón Virasoro

Authors
  1. Jessica DeLong
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  2. Kurt McCammon
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  3. Leandro Capiel
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  4. Augustín Rovegno
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  5. Jeremy B. Tonkin
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  6. Gerald Jordan
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  7. Ramón Virasoro
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Corresponding author

Correspondence to Ramón Virasoro.

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Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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DeLong, J., McCammon, K., Capiel, L. et al. Augmented perineal urethrostomy using a dorsal buccal mucosal graft, bi-institutional study. World J Urol 35, 1285–1290 (2017). https://doi.org/10.1007/s00345-017-2002-z

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  • DOI: https://doi.org/10.1007/s00345-017-2002-z

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