Female buccal mucosa graft urethroplasty: a new modified ventral onlay “AZ” technique

Abstract

Introduction and hypothesis: To present the surgical details and the outcomes of our modified ventral onlay buccal mucosal graft (BMG) urethroplasty technique in female patients with urethral strictures. Methods: We included the first seven female patients who had BMG urethroplasty between January 2015 and April 2019 and had at least 6 months of follow-up. Patient age, stricture length, comorbidities, number of previous treatments, pre- and postoperative uroflowmetry data, and post-void residual volumes were recorded. Results: The mean patient age was 56.7 (44–80) years. The mean stricture length was 3.1 (2–4) cm. The mean postoperative follow-up time was 23 (7–48) months. The preoperative mean maximal flow rate (Qmax) was 5.1 (3.2–9.5) ml/s and post-void residual urine volume (PVR) was 84.4 (37–158) ml. At the 3rd month after surgery, mean Qmax was 31.8 (24.7–36.2) ml/s, and PVR volume was 7.1 (0–16) ml. Three patients had the postoperative 2-year follow-up, and 12th and 24th month mean Qmax values were 28 (23.6–33.2) ml/s and 28.5 (24.1–31.1) ml/s, respectively. The mean operation time was 63.8 (55–113) min. We did not observe any infection, vaginal erosion, urinary incontinence, or oral discomfort due to graft harvesting postoperatively. Conclusion: Female urethroplasty provides high cure rates and should be performed in case of recurrent FUS. The early and medium-term results of our modified new technique indicated that it might be used as a simple alternative to current techniques. In all of our patients, it significantly increased the flow rate and reduced PVR without any significant complications. © 2020, The International Urogynecological Association.