Mucosal sparing quilting of buccal mucosal graft in dorsal onlay urethroplasty: description of the technique and preliminary results

To assess the outcome of mucosal sparing quilting technique in buccal mucosal graft dorsal onlay urethroplasty. Twenty three patients with non-traumatic anterior urethral stricture were included in the study and data were retrospectively reviewed. Patients with history of trauma, previous failed urethroplasty and completely obliterative strictures were excluded Urethroplasty was done through transperineal approach. After incising the stricture dorsally, buccal graft was quilted by sutures passing through the undersurface of graft to corporeal bodies sparing the mucosal surface, and then sutured to urethral plate. At follow-up, failure was defined as the presence of obstructive symptoms and/or maximum urinary flow rate (Q.max) less than 15 ml/sec confirmed by retrograde urethrogram and diagnostic urethrocystoscopy. The median (range) age was 35 (18–60) years. The median (range) length of stricture was 4 (1.5–15) cm. Urethral stricture was idiopathic in 52.2% and bulbar urethra was the most common site of stricture (47.8%). The median (range) follow-up was 13 (6–20) months. Success rate was 87% after at least 6 months follow-up. Mucosal sparing quilting of BMG is technically feasible and has encouraging results in dorsal onlay urethroplasty for anterior urethral stricture disease.