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• W2013097414 abstract "You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery (II)1 Apr 201386 BUCCAL MUCOSAL URETHROPLASTY AFTER FAILED PRIOR OPEN REPAIR: A SINGLE INSTITUTION EXPERIENCE Matthew Mellon, Ronald Boris, and Richard Bihrle Matthew MellonMatthew Mellon Indianapolis, IN More articles by this author , Ronald BorisRonald Boris Indianapolis, IN More articles by this author , and Richard BihrleRichard Bihrle Indianapolis, IN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1464AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Buccal mucosal graft urethroplasty (BMG) is a widely utilized technique for surgical reconstruction of urethral stricture disease. Patients with failed prior open urethroplasty can be challenging to manage and definitive treatment algorithms are ill-defined. This study aims to evaluate the long term outcomes of BMG performed as a salvage technique after failed open urethroplasty. METHODS 114 consecutive patients underwent BMG at a single institution between 2001 and 2009. Of these, 32 had undergone prior failed open urethroplasty and compromised our study cohort. 28 patients had a single prior attempted open repair: 10 (31.2%) primary anastomosis, 7 (21.9%) failed formal hypospadias repairs, 6 (18.6%) prior pedicle island flaps, and 5 (15.6%) attempted buccal mucosal grafts. Four patients had undergone multiple prior open attempts at reconstruction including a combination of pedicle flap and Johansen-type graft, buccal graft and Johansen-type graft (2), and buccal graft with pedicle flap failure. Amongst the salvage cohort, 20 (62.5%) patients had bulbar stricture disease and 12 (37.5%) had penile urethral involvement. Demographic, surgical, and functional outcome data was retrospectively reviewed. RESULTS Overall mean follow-up was 26.6 months (range 6-91). Mean stricture length was 3.1cm (range 1.0-8.0). Graft failure rate was 37.5%, defined as the inability to pass a cystoscope. Ten patients (34%) required repeat surgery including: meatotomy (2), formal dilation (6), DVIU (1) and revision buccal graft urethroplasty (1). The mean time to failure was 10.8 months (0.7 – 60.1). CONCLUSIONS BMG as a salvage technique provides satisfactory results for the reconstructive management of recurrent urethral stricture disease after failed prior urethroplasty. Despite encouraging outcomes, graft failures present at increased rates in this setting. Stricture recurrences in this patient population may occur immediately following repeat surgery or develop in a delayed fashion necessitating close, long term follow-up. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e35-e36 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Mellon Indianapolis, IN More articles by this author Ronald Boris Indianapolis, IN More articles by this author Richard Bihrle Indianapolis, IN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2013097414 title "86 BUCCAL MUCOSAL URETHROPLASTY AFTER FAILED PRIOR OPEN REPAIR: A SINGLE INSTITUTION EXPERIENCE" @default.
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