Local Penile Skin Flap versus Buccal Mucosal Graft Urethroplasty for Urethral Stricture: A Prospective Randomized Study

Background: Urethral stricture management remains a complex challenge in urology, requiring tailored surgical approaches to optimize outcomes. Local Penile Skin Flap (LPF) and Buccal Mucosal Graft (BMG) urethroplasties are two main techniques with distinct advantages and limitations. Methods: This prospective, randomized study included 52 male patients with anterior urethral strictures, divided into two groups to receive either LPF or BMG urethroplasty. Patients were followed for six months, evaluating etiology, intraoperative details, postoperative complications, and success rates. Results: Both techniques showed high success rates, with 94.4% in the BMG group and 93.7% in the LPF group achieving optimal uroflowmetry scores. BMG was associated with longer operative times and slightly higher donor site morbidity, whereas LPF showed a higher incidence of penile curvature. Conclusion: LPF and BMG both provide high efficacy in urethral stricture repair, with specific considerations influencing the choice of technique. BMG offers a robust solution for complex strictures, while LPF may be preferred for shorter operative times despite the risk of penile curvature.