Urologic Survey (Reconstructive Urology)

In the treatment of urethral stricture, Buccal Mucosa Graft (BMG) and...

J Urol Surg 2014;1(1):49-49

EDITORIAL COMMENT In the treatment of urethral stricture, Buccal Mucosa Graft (BMG) and reconstruction is applied with different patch techniques. Recently often prefered, this approach is, in bulber urethra strictures of BMG’s; by “ventral onley”, in pendulous urethra because of thinner spingiosis body, which provides support and nutrition of graft; by means of “dorsal inley” being anastomosis. In the research that Cordon et al. did, they compared conventional BMJ “onley” urethroplast and “pseudo-spongioplasty” which base on periurethral vascular tissues to be nourished by closing onto graft. In repairment of front urethras that spongiosis supportive tissue is insufficient, this method is defined as peripheral dartos [çevre dartos?] and buck’s fascia being mobilized and being combined on BMG patch. Between the years 2007 and 2012, assessment of 56 patients with conventional “ventral onley” BMG urethroplast and 46 patients with “pseudo-spongioplasty” were reported to have similar success rates (80% to 84%) in 3.5 year follow-up on average. While 74% of the patients that were applied pseudo-spongioplasty had disease present at distal urethra (pendulous, bulbopendulous), 82% of the patients which were applied conventional onley urethroplast had stricture at proximal (bulber urethra) yet. Also lenght of the stricture at the pseudo-spongioplasty group was longer in a statistically significant way (5.8 cm to 4.7 cm on average, p=0.028). This study which Cordon et al. did, shows that conditions in which conventional sponjiyoplasti is not possible, periurethral vascular tissues are adequate to nourish BMG. Even it is an important technique in terms of bringing a new point of view to today’s practice, data especially about complications that may show up after pseudo-spongioplasty usage on long distal strictures (e.g. appearance of urethral diverticulum) is not reported. Along with this we think that, providing an oppurtinity to patch directly without urethra mobilization need or extra dissection in the conditions that surgeon has preferred BMG in distal urethra reconstruction, this method will be a valuable alternative in the selected facts. Fikret Fatih Önol MD