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Saudi Journal of Medical and Pharmaceutical Sciences (SJMPS)
Volume-11 | Issue-07 | 502-508
Original Research Article
Outcome of Dorsolateral Buccal Mucosal Graft Urethroplasty in Comparison to Dorsal Onlay Urethroplasty for Long Segment Anterior Urethral Stricture
Mahmud Ul Alam Mondal, Md. Zahurul Haque, Marufatul Mamduda Tina, Hafiz Al-Asad, Md. Rabiul Islam
Published : July 1, 2025
DOI : https://doi.org/10.36348/sjmps.2025.v11i07.002
Abstract
Background: Location of placement of the graft either dorsally, dorsolaterally or ventrally for the treatment of long segment anterior urethral stricture has become an issue with different series reporting different outcomes. Regarding dorsolateral and dorsal onlay technique, there are various published articles worldwide. In Bangladesh, there are limited study regarding the issue though there are lots of patients suffering from urethral stricture disease. Objective: Objective of the study is to compare the outcomes of these two techniques. Method: Present Quasi experimental study was conducted in the department of Urology, Rangpur Medical College Hospital & KMMCH, Rangpur, Bangladesh, during the period of October 2022 to September 2024. Total 50 patients with long segment (>2 cm) anterior urethral stricture were included in present study. Among them 25 patients underwent dorsolateral (group-A) and another 25 patients underwent dorsal onlay (group-B) urethroplasty. Patients were followed up for 06 months. Result: Mean ± SD age of group-A and Group-B were 43.72 ± 7.64 and 44.08 ± 7.56 years respectively (p >0.05). Mean ± SD of length of stricture of group-A and Group-B were 4.25±1.28 and 4.22±1.31 cm respectively (p >0.05). In Group-A and Group-B preoperative mean Peak urine flow rate on uroflowmetry (Qmax) were 6.68±1.35 and 7.00±1.46 ml/sec respectively (p >0.05). Mean post-operative Qmax were 20.00±3.20 & 20.52±4.38 ml/sec in Group-A, and 19.39±3.13 & 19.19±4.93 ml/sec in Group-B, on 1st and 2nd follow up respectively (p >0.05). There was statistically significant difference of mean Qmax in the same group before and after BMG urethroplasty. Success was defined as peak urine flow rate on uroflowmetry ≥15ml/sec with no stricture diagnosed on RGU & VCUG and urethroscopy, and no need of any post-operative urethral intervention. Re-stricture developed in 2 (8.0%) cases in Group-A and 4 (16.0%) cases in Group-B which needed urethral intervention. Success rate was 23(92%) cases and 21(84%) cases in group A and group B respectively (p >0.05). 02(8.0%) cases in Group-A and 03(12%) cases in Group-B had wound infection, 1(4.0%) case in Group-A and 3 (12%) cases in Group-B had chordee. Urethrocutenous fistula developed in 1 (4.0%) case in Group-A and 3 (12.0%) cases in Group-B; results between the two groups were not statistically significant. Conclusion: Outcome of dorsolateral buccal mucosal graft urethroplasty was comparable with dorsal onlay urethroplasty in present study. Well controlled randomized study with adequate sample size and follow up may reveal more divergent outcomes.
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