Abstract
Traditionally, anastomotic procedures with transection and urethral excision are suggested for short bulbar strictures, while longer strictures are treated by patch graft urethroplasty preferably using the buccal mucosa as gold-standard material due to its histological characteristics.
However, one-sided graft procedures, using either dorsal or ventral graft location, could be insufficient in providing a lumen of adequate width in strictures with a particularly narrow area.
The double buccal graft urethroplasty is a new technique that aims to obtain a sufficient “two-sided” augmentation of the urethra avoiding its transection and preserving the urethral plate.
In this chapter we discuss the rationale for utilizing our procedure. In addition, the surgical technique is described in detail.
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References
Andrich DE, Mundy AR. What is the best technique for urethroplasty? Eur Urol. 2008;54:1031–41.
Mangera A, Patterson MJ, Chapple CR. A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures. Eur Urol. 2011;59:797–814.
Wang K, Miao X, Wang L, Li H. Dorsal versus ventral onlay urethroplasty for anterior urethral stricture: a meta-analysis. Urol Int. 2009;83:342–8.
Palminteri E, Manzoni G, Berdondini E, et al. Combined dorsal plus ventral double buccal mucosa graft in bulbar urethral reconstruction. Eur Urol. 2008;53:81.
Burger RA, Muller SC, El-Damanhoury H, et al. The buccal mucosa graft for urethral reconstruction: a preliminary report. J Urol. 1992;147:662.
Morey AF, McAninch JW. When and how to use buccal mucosal grafts in adult bulbar urethroplasty. Urology. 1996;48:194–8.
Wessels H, Mc Aninch JW. Use of free grafts in urethral stricture reconstruction. J Urol. 1996;155:1912–5.
Asopa HS, Garg M, Singhal GG, et al. Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach. Urology. 2001;58:657–9.
Barbagli G, Selli C, Tosto A, et al. Dorsal free graft urethroplasty. J Urol. 1996;155:123–6.
Barbagli G, Palminteri E, Guazzoni G, et al. 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.
Iselin CE, Webster GD. Dorsal onlay graft urethroplasty for repair of bulbar urethral stricture. J Urol. 1999;161:815–8.
Barbagli G. Buccal mucosa graft urethroplasty. In: Brandes SB, editor. Urethral reconstructive surgery. Totowa: Humana press; 2008. p. 119–35.
Presman D, Greenfield DL. Reconstruction of the perineal urethra with a free full-thickness skin graft of the prepuce. J Urol. 1953;69:677–80.
Elliott SP, Metro MJ, McAninch JW. Long-term followup of the ventrally placed buccal mucosa onlay graft in bulbar urethral reconstruction. J Urol. 2003;169:1754–7.
Barbagli G. Editorial comment on: dorsal buccal mucosal graft urethroplasty for anterior urethral striature by Asopa technique. Eur Urol. 2009;56:205–6.
Abouassaly R, Angermeier KW. Augmented anastomotic urethroplasty. J Urol. 2007;177:2211–5.
Palminteri E, Berdondini E, Shokeir A, et al. Two-sided bulbar urethroplasty using dorsal plus ventral oral graft: urinary and sexual outcomes of a new technique. J Urol. 2011;185:1766–71.
Guralnick ML, Webster GD. The augmented anastomotic urethroplasty: indications and outcome in 29 patients. J Urol. 2001;165:1496–501.
Morey AF, Kizer WS. Proximal bulbar urethroplasty via extended anastomotic approach – what are the limits? J Urol. 2006;175:2145–9.
Barbagli G, De Angelis M, Romano G, et al. Long-term followup of bulbar end-to-end anastomosis: a retrospective analysis of 153 patients in a single center experience. J Urol. 2007;178:2470–3.
Mundy AR. Results and complications of urethroplasty and its future. Br J Urol. 1993;71:322–5.
Al-Qudah HS, Santucci RA. Buccal mucosal onlay urethroplasty versus anastomotic urethroplasty (AU) for short urethral strictures: which is better? J Urol. 2006;175(suppl):103, abstract 313.
Palminteri E, Berdondini E, Colombo F, et al. Small intestinal submucosa (sis) graft urethroplasty: short-term results. Eur Urol. 2007;51:1695–701.
Manzoni G, Bracka A, Palminteri E, et al. Hypospadias surgery: when, what and by whom? BJU Int. 2004;94:1188–95.
Coursey JW, Morey AF, McAninch JW, et al. Erectile function after anterior urethroplasty. J Urol. 2001;166:2273–6.
Kessler T, Fish M, Heitz M, et al. Patient satisfaction with the outcome of surgery for urethral strictures. J Urol. 2002;167:2507–11.
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Palminteri, E., Berdondini, E. (2014). Double Overlapping Buccal Grafts. In: Brandes, S., Morey, A. (eds) Advanced Male Urethral and Genital Reconstructive Surgery. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7708-2_33
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DOI: https://doi.org/10.1007/978-1-4614-7708-2_33
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