Dorsal‐ vs ventral‐onlay buccal mucosal graft urethroplasty for urethral strictures: a meta‐analysis

IF 3.7 2区医学 Q1 UROLOGY & NEPHROLOGY

BJU International Pub Date : 2025-06-09 DOI:10.1111/bju.16811

Atef A. Hassan, Ahmed Mohamed Soliman, Hossam Ahmed Shouman, Mohamed Ibrahim Algammal, Mohamed Fawzy Salman, Mohamed Abdallah Hindawy, Ibrahim Tagreda, Mohamed Elsalhy, Ahmed Alrefaey, Hesham Abozied, Hassan Abdelazim, Mohammed Agha, Moaz Elsayed Abouelmagd, Mohamed Hamouda Elkasaby, Hesham Abdel‐Azim El‐Helaly

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引用次数: 0

Abstract

ObjectiveTo compare ventral‐ and dorsal‐onlay buccal mucosal graft (BMG) urethroplasty in patients with urethral stricture, as the optimal placement of BMG in urethroplasty for bulbar urethral strictures remains debated.MethodsA systematic search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library. Studies comparing dorsal‐ and ventral‐onlay BMG urethroplasty were analysed. Pooled effect sizes were calculated using a random‐effects model. Subgroup analyses and publication bias assessments were performed.ResultsEight studies with 655 patients were included. The success rate showed no significant difference between the dorsal‐ and ventral‐onlay techniques (relative risk [RR] 1.00, 95% confidence interval [CI] 0.94–1.06; P = 0.97, I2 = 0%). The maximum urinary flow rate at 3 months (mean difference [MD] −0.64, 95% CI −2.14 to 0.86 mL/s; P = 0.41) and 12 months (MD −0.57, 95% CI −2.00 to 0.85 mL/s; P = 0.43) was comparable. Transient erectile dysfunction (ED) was significantly lower with the ventral technique (RR 0.24, 95% CI 0.08–0.67; P = 0.006), while permanent ED rates were similar (RR 0.57, 95% CI 0.03–12.20; P = 0.72). Sensitivity analysis confirmed robustness, and no publication bias was detected.ConclusionDorsal‐ and ventral‐onlay BMG urethroplasty have similar success rates and urinary flow outcomes. However, ventral onlay may reduce transient ED.International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD420250654329.

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背侧与腹侧颊粘膜移植尿道成形术治疗尿道狭窄：一项荟萃分析

目的比较腹侧和背侧颊粘膜移植（BMG）尿道成形术在尿道狭窄患者中的应用，因为BMG在球型尿道狭窄尿道成形术中的最佳放置位置仍存在争议。方法系统检索PubMed、Scopus、Web of Science、Cochrane Library。比较背侧和腹侧膀胱尿道成形术的研究进行了分析。使用随机效应模型计算合并效应大小。进行亚组分析和发表偏倚评估。结果共纳入8项研究，655例患者。成功率显示背侧和腹侧贴装技术之间无显著差异(相对危险度[RR] 1.00, 95%可信区间[CI] 0.94-1.06；P = 0.97, i2 = 0%)。3个月时最大尿流率(平均差[MD] - 0.64, 95% CI - 2.14 ~ 0.86 mL/s；P = 0.41)和12个月(MD - 0.57, 95% CI - 2.00 ~ 0.85 mL/s；P = 0.43)具有可比性。短暂性勃起功能障碍（ED）明显低于腹侧技术(RR 0.24, 95% CI 0.08-0.67；P = 0.006)，而永久性ED发生率相似(RR 0.57, 95% CI 0.03-12.20；P = 0.72)。敏感性分析证实了稳健性，未发现发表偏倚。结论背侧和腹侧膀胱输尿管成形术具有相似的成功率和尿流量结果。然而，腹侧延迟可能会减少短暂ed。国际前瞻性系统评价注册（PROSPERO）注册号：CRD420250654329。

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

BJU International 医学-泌尿学与肾脏学

CiteScore

9.10

自引率

4.40%

发文量

262

审稿时长

1 months

期刊介绍： BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.