Urethral Stricture: A Comparison Between Jugal or Labial Graft Urethroplasty

Urethral Stricture Repair: A Prospective Randomized Analysis Between Jugal or Labial Graft in Buccal Mucosa Urethroplasty

Buccal mucosa urethroplasty is a current fashion in urethral stricture management. In our university centre (Hospital de Clínicas de Porto Alegre) is a common surgical treatment choice. This paper aims to evaluate the success rate of this treatment after randomized choice between labial and jugal (inner cheek) grafts during the past two years.

Free dorsal graft urethroplasty, first described by Barbagli et al, has been shown better results than ventral grafts. Fixed grafts on the corpora cavernosa results in a better mechanical support and vascular supply, with less chance to complications such as pseudodiverticula and sacculations either a better urethral phisiology. This study aims to evaluate the current surgical management in our centre: buccal mucosa graft urethroplasty with jugal or labial replacement, comparing their group success rate and complications between the groups in patients led to surgery from October 2016 to June 2018. Prospective analysis from urethral stricture surgical HCPA patient data by dorsal buccal mucosa graft urethroplasty. The graft choice were done by a software. Longer stricture with transoperative need for the two grafts use were excluded. Success rate were measured with a no stricture de novo or absence of complications in a six month interval.

As replacement of the damaged urethral tissue, we used a buccal mucosa graft(inner cheek - jugal graft).

Absence of surgical intervention on patients who used a latex catheter indwelling after prior surgery.

Absence of surgical intervention on patients who used a silicon catheter indwelling after prior surgery.

Evaluation of the etiology of the stricture (trauma, other, infectious) on patients included on Labial and Jugal Groups

Evaluation of the stricture localization (penile, bulbar/bulbomembranous or combined) on patients included on Labial and Jugal Groups

Evaluation of the demographic data relationship with the results (age, cystotomy, cystostomy time, tobacco use, diabetes, balanitis xerotica, UTI infection, serum creatin levels) included on Labial and Jugal groups

Inclusion Criteria: Urethral Stricture Diagnosis Indication for buccal mucosa graft urethroplasty Accept the Informed Consent Term (patient or responsible) Exclusion Criteria: Severe urethral stricture which a two-staged procedure are required Long strictures which need a both types of buccal mucosa graft due its length. Refuse to ICT for the patient ou it responsible

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