Comparative Efficacy of Dorsal-Onlay and Ventral-1 Inlay Buccal Mucosal Graft Urethroplasty in Female Urethral Stricture: A Randomized Clinical Trial

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-06-01 DOI:10.1016/j.urology.2025.01.064

Swarnendu Mandal , Abhay Singh Gaur , Kirti Singh , Manoj Kumar Das , Sambit Tripathy , Vivek Tarigopula , Suman Sahoo , Kalandi Barik , Prasant Nayak

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Abstract

Objective

To compare the outcomes of dorsal-onlay (DO) and ventral‑inlay (VI) buccal mucosal graft urethroplasty (BMGU). This is the first Clinical Trials Registry-India registered randomized clinical trial on female urethral stricture disease.

Methods

Women with USD underwent either DO-BMGU or VI-BMGU between September 2021 to July 2023. The primary objective was the success rates of the two techniques. The secondary objectives were duration of surgery, amount of blood loss, pain scores as assessed by Visual Analog Scale, and change in American Urological Association score, Qmax and postvoid residual.

Results

Of the 47 randomized participants, 20 patients in each group were taken up for final analysis.

The median follow‑up period was 21 months and those with less than 1 year follow-up were excluded. One patient in each group had failure at 1 year follow-up, giving a success rate of 95% in each arm.

The median blood loss [15 mL (10-15) vs 10 mL (5-12.5), (P .012)] and median duration of surgery [44.5 minutes (40-52.5) vs 30 minutes (22-38), (P <.001)] were significantly less for VI-BMGU than for DO-BMGU. The median Visual Analog Scale scores at 6 and 24 hours were significantly lower (P <.001) for the VI-BMGU group but not at 48 hours. The VI-BMGU group required less analgesia (P <.01) as well. Small sample size and single institutional experience are limitations.

Conclusion

The outcomes of VI-BMGU are similar to those of DO-BMGU, with the additional advantages of shorter operative time, lesser blood loss, and less pain.

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一项随机临床试验：背侧-嵌体与腹侧-1嵌体颊黏膜移植尿道成形术治疗女性尿道狭窄的疗效比较。

目的：比较背侧嵌体（DO）和腹侧嵌体（VI）颊粘膜移植尿道成形术（BMGU）的效果。这是印度临床试验注册中心（CTRI）注册的首个F-USD随机对照试验。方法：在2021年9月至2023年7月期间，患有USD的女性接受了DO-BMGU或VI-BMGU。主要目标是两种技术的成功率。次要目标是手术时间、出血量、VAS评估的疼痛评分、AUA评分、Qmax和PVR的变化。结果：47例随机受试者中，每组20例纳入最终分析。中位随访期为21个月，排除随访时间少于1年的患者。在1年随访中，每组均有1例患者失败，每组的成功率为95%。中位失血量[15 ml (10-15) vs 10 ml (5-12.5), (p 0.012)]和中位手术时间[44.5分钟（40-52.5）vs 30分钟（22-38）],(p结论：VI-BMGU的结果与DO-BMGU相似，具有更短的手术时间，更少的失血量和更少的疼痛。试验报名：CTRI注册号- CTRI/2021/09/036502。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.