Buccal mucosa: is it ideal for long segment stricture urethroplasty?

Background: Reconstruction of male urethra poses a continuing urological challenge. The ideal material for substitution urethroplasty remains controversial. Candidate tissues have included split and full thickness skin graft from scrotum, penis and extra-genital areas like bladder mucosa and buccal mucosa. This study was done to evaluate the short term and long-term results of buccal mucosal urethroplasty and analyzed them with different variables like etiology of stricture, length of stricture, operative procedure and associated complications and success rate. Material and Methods: All the Cases of anterior stricture urethra who had stricture length more than 1 cm and who underwent buccal mucosal substitution urethroplasty were included in this study. The short term and long-term results of buccal mucosal substitution urethroplasty were assessed. Patients were divided into two groups according to their length, patients with stricture length up to 6 cm and 7 cm or more and the results of buccal mucosal substitution urethroplasty were assessed in terms of etiology of stricture, length of stricture, operative procedure and its associated complications and success rate. Results: In the present study, the success rate of long segment strictures was inferior (77%). The success rate of two staged BMGU for long segment strictures was satisfactory (80%) if not associated with proximal urethral stenosis. Success rate of urethral strictures associated with BXO was lower (75%) as compared to others. Success rate of BMGU with almost tube (50%) was very poor. Conclusion: Buccal mucosa gives a good and viable option for substitution urethroplasty for long segment stricture. It is easy to harvest and handle, is resilient to infections and accustomed to a wet environment. As of date, it provides good material for substitution for treating all types of strictures with fairly good results and fewer complications.