Siddiqur Rahman1, Guljar Ahmed2, Serajul Haque3, Sajid Hasan4, MA Salam5
1. Associate professor. Department of Urology, North East Medical College, Sylhet
2. Associate professor, Department of Surgery, North East Medical College, Sylhet
3. Associate professor, Department of Urology, Comilla Medical College, Comilla
4. Professor, Department of Urology, BSMMU, Dhaka
5. Professor, Department of Urology, BSMMU, Dhaka
Abstract
Introduction: For most people with urethral stricture disease either dilatation or urethrotomy are palliative management rather than curative treatment. Buccal mucosal graft (BMG) substitution urethroplasty has become popular in the management of anterior urethral strictures with good results. Encouraging long-term results have been reported by both dorsal and ventral onlay technique. The present work has been carried out to compare the outcome of ventral buccal mucosal graft (BMG) urethroplasty by ventral urethrotomy approach and dorsal buccal mucosal graft (BMG) urethroplasty by Barbagli’s modification of Monseur’s technique for the long segment anterior urethral strictures.
Method: From July 2004 to December 2006 a prospective and comparative study was done on men having long segment (20-60 mm) anterior urethral stricture, in the Department of urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. A total of 70 patients were evaluated, admitted and underwent buccal mucosal graft Urethroplasty. Urethra was approached through perineal incision and graft was placed at ventral aspect in 35 cases and at dorsal aspect in 35 cases and then followed up for one year.
Result: A total number of 67 Patients, 35 patients with ventral graft (Group-A) and 32 patients with dorsal graft (Group-B) were followed up to 12th month. Overall final outcome between the two Groups observed. In Group-A success rate was 60% and in Group-B success rate is 93.8%. Success rate between the two Groups was compared and found statistically significant.
Conclusion: The outcome of dorsal buccal mucosal graft urethroplasty is better than the ventral graft.
Key words: Urethral stricture, buccal mucosa, graft, urethroplasty.