Clinical observation of transurethral reconstruction of urethral meatus and navicularis fossa short strictures with annular inlay oral mucosa graft urethroplasty.

Objective: This study aims to explore the clinical efficacy and safety of a urethroplasty technique for fossa navicularis (FN) strictures using a transurethral annular inlay oral mucosa graft.

Methods: A retrospective analysis was conducted on clinical data from patients with urethral meatus and navicular fossa stricture who underwent transurethral reconstruction using annular inlay oral mucosa graft urethroplasty in Tangdu Hospital from July 2021 to October 2024. Operation success was defined as the ability to pass the F24 urethral probe, and the secondary outcome is the urinary flow rate and patient satisfaction at 1, 3, 6, and 12 months.

Results: All 12 patients successfully completed the surgery. The average age was 56.8 ± 6.8 years, and the average length of urethral stricture was 1.6 ± 0.2 cm. Three patients had a history of transurethral endoscopic surgery, eight had penile lichen sclerosus (LS), and one had no obvious causes. Over a median follow-up of 19 months, the average maximum urinary flow rate was 21.2 ± 3.2 ml/s at 3 months, and the average maximum urinary flow rate was 19.5 ± 4.2 ml/s at 12 months. One patient experienced urine pain with a thin stream and spraying urination after 3 months. Physical examination of the urethral meatus opening scar was found, and the symptoms disappeared after urethral incision. The follow-up survey of sexual life after 1 year showed that seven patients (58.3%) had successful life within 1 year compared with two patients (16.7%) before surgery. There were no cases of erectile dysfunction and poor wound healing. The patients were either very satisfied (75%) or satisfied (25%) with the operation. All patients would recommend urethroplasty to others.

Conclusion: Transurethral annular inlay oral mucosa urethroplasty for urethral meatus and navicular fossa stricture reconstruction is a safe, feasible, and effective surgical method, cosmetic effect on the penile head. This technique has advantages in improving sexual function and better penile head cosmesis.