Penile Skin Versus Buccal Mucosal Graft in Augmentation Urethroplasty for Long Anterior Urethral Stricture

Tanta University

Status: Enrolling

Conditions: Urethroplasty; Buccal Mucosal Graft; Urethral Stricture; Long Anterior; Augmentation; Penile Skin

Treatments: Procedure: Buccal Mucosal Graft (BMG) Urethroplasty; Procedure: Penile Skin Graft (PSG) Urethroplasty

Study type: Interventional

Funder types: Other

Identifiers

NCT07074717

36264PR1074/1/25

Details and patient eligibility

About

The aim of this study is to analyze the outcomes of dorsal onlay buccal mucosal graft (BMG) and penile skin graft (PSG) urethroplasty in the management of long segment bulbar urethral stricture.

Full description

Penile urethral reconstruction proves to be a continuous challenge as no perfect technique is considered for all patients with this problem. Among all the methods used for treatment of urethral stricture, the substitution urethroplasty with tissue transfer using either flap or graft is the gold standard treatment option for long segment urethral strictures.

In 1993, McAninch described a circular fasciocutaneous flap for the management of penile urethral stricture up to 15 cm that showed excellent cosmetic and functional outcomes due to this being a hairless, flexible flap with a rich vascular supply.

Buccal mucosal graft (BMG) was rediscovered and popularized in 1992 by Burger et al., then El-Kassaby et al. in 1993 published a series using buccal mucosal graft to repair anterior urethral stricture. Buccal mucosal graft became an ideal urethral substitute due to easy harvesting, hairlessness and compatibility in a wet environment.

Enrollment: 80 estimated patients

Sex: Male

Ages: 18+ months old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with long segment anterior urethral stricture that was defined as a stricture with a length of more than 1 cm with spongiofibrosis.
• Patients with previous failed urethral dilatation or direct vision internal urethrotomy (DVIU)

Exclusion criteria

• Patients with lichen sclerosus
• Patients with history of hypospadias repair
• Patients with recurrent urethral stricture after failed previous urethroplasty

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 2 patient groups

Buccal Mucosal Graft (BMG)

Experimental group

Description:

Participants will undergo dorsal onlay augmentation urethroplasty using a buccal mucosal graft harvested from the inner cheek. The procedure is performed under spinal or general anesthesia. Graft is sutured dorsally over the strictured urethral segment after excision of the fibrotic tissue.

Treatment:

Procedure: Buccal Mucosal Graft (BMG) Urethroplasty

Penile Skin Graft (PSG)

Experimental group

Description:

Participants will undergo dorsal onlay augmentation urethroplasty using a penile skin graft harvested from the ventral surface of the penis. The hairless skin is prepared and sutured dorsally over the strictured urethral segment. The procedure is done under spinal or general anesthesia.

Treatment:

Procedure: Penile Skin Graft (PSG) Urethroplasty