Pérez-Becerra R, Morales-Montor JG, Santana-Ríos Z, Fulda-Graue SD, Urdiales-Ortiz A, Fernández-Noyola G, Martínez JÁ, Ahumada-Tamayo S, Muñoz-Ibarra EL, Camacho-Castro AJ, García-Salcido F, Garza-Sainz G, Osornio-Sánchez V, Martínez-Arroyo C, Cantellano-Orozco M, Pacheco-Gahbler C

Language: Spanish
References: 14
Page: 22-26
PDF size: 532.61 Kb.

ABSTRACT

Introduction: Urethral stricture treatment in the adult is a urological challenge. Strictures larger than 3 cm are managed through the use of tissue (skin or buccal mucosa). When substitution procedures are necessary, different types of tissues have been used, including genital skin, extragenital skin, bladder mucosa, and buccal mucosa. These have been used as pedunculated flaps or as free grafts. The use of buccal mucosa was first described in 1941. Its immunological advantages reduce infection and aid recurrence resistance. The objective of the present article was to present the surgical technique employed in a case of recurrent complex urethral stricture that was managed with posterior buccal mucosa graft.
Clinical case: Patient is a forty-one-year-old man, who presented with weakened strength and caliber of urinary flow, straining, and bladder tenesmus. His International Prostate Symptom Score was twenty points. Urethral stricture was documented and was initially managed with endoscopic urethrotomy. One year later patient presented with recurrence and the decision was made to carry out end-to-end urethroplasty and cystotomy, which failed. Control urethrography showed stricture with a length of 4 cm. Urethroplasty with a posterior buccal mucosa flap was performed.
Conclusions: Despite the fact that different tissues and substitutes are used in urethral reconstruction, buccal mucosa has been the most widely used for more than a decade. It is a reproducible technique and in well-trained hands, offers a high success rate.

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