Comparison of Closure Versus Non-Closure of Buccal Mucosal Graft Harvest Site Outcomes in Urethroplasty

Abstract

Background: Urethroplasty is open surgical reconstruction of urethral stricture disease and it depends on the site of stricture and the used technique either by excision and primary anastomosis, on-lay repair, stricture excision and augmented anastomosis, flap-based repair, and staged repair.

Objective: This study aimed to improve postoperative outcomes of the buccal mucosal graft harvest site by comparing closure versus non-closure of the harvest site.

Patient and Methods: This prospective comparative study was conducted on 34 patients with urethral stricture planned to be managed by buccal mucosal graft (BMG) urethroplasty. Those 34 patients attended to urology outpatient clinic at Zagazig university hospital from September 2019 to December 2020.

Results: Intraoperatively, two patients were found to have short stricture (approximately 1 cm) with dense spongiofibrosis and they were managed by anastomotic urethroplasty. Post-operative pain was maximal on the first day in both groups but it was more significant in the closure group by the second day.

Conclusions: Buccal mucosal graft harvesting is well tolerated by all patients. The pain appears to be worse in the immediate postoperative period after suturing the harvest site.