Buccal Mucosal Graft Urethroplasty for the Treatment of Urethral Stricture in the Neophallus

Joseph J. Pariser, Joshua A. Cohn, Lawrence J. Gottlieb, Gregory T. Bales

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective To present our operative approach and outcomes with buccal mucosal graft urethroplasty for anastomic stricture in the neophallus. Methods All patients who underwent buccal mucosal graft urethroplasty by a single surgeon for urethral stricture in a neophallus between March 1998 and June 2013 were identified. Urethroplasties were performed using 1-stage ventral onlay buccal mucosal graft after incision of the stricture. Results Ten patients were included in analysis. One patient underwent creation of neophallus after trauma, whereas all others were performed as gender reassignment. In all patients, strictures were located at the anastomosis between the native and the neourethra. Mean age was 39 years (range, 26-56 years). Mean stricture length was 3.6 cm (range, 2-6 cm). Median follow-up was 9.5 months (range, 2.7-84 months). At last follow-up, all the first 3 patients had stricture recurrence, whereas 5 of the next 7 patients remained free of stricture (overall success rate, 50%). A total of 11 follow-up procedures were performed for recurrent strictures in these patients, including 8 internal urethrotomies, 1 suprapubic tube placement, and 2 repeat urethroplasties. The only perioperative complication was a patient who experienced mild rhabdomyolysis, which resolved with supportive measures. Conclusion Experience with urethral strictures in the neophallus is limited, and management is complex. Buccal mucosal graft urethroplasty may be more effective than endoscopic management, but failure remains common. Modifications in surgical approach and experience may improve outcomes.

Original languageEnglish (US)
Pages (from-to)927-931
Number of pages5
JournalUrology
Volume85
Issue number4
DOIs
StatePublished - Apr 1 2015

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Urethral Stricture
Cheek
Pathologic Constriction
Transplants
Therapeutics
Inlays
Rhabdomyolysis
Recurrence
Wounds and Injuries

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Buccal Mucosal Graft Urethroplasty for the Treatment of Urethral Stricture in the Neophallus. / Pariser, Joseph J.; Cohn, Joshua A.; Gottlieb, Lawrence J.; Bales, Gregory T.

In: Urology, Vol. 85, No. 4, 01.04.2015, p. 927-931.

Research output: Contribution to journalArticle

Pariser, Joseph J. ; Cohn, Joshua A. ; Gottlieb, Lawrence J. ; Bales, Gregory T. / Buccal Mucosal Graft Urethroplasty for the Treatment of Urethral Stricture in the Neophallus. In: Urology. 2015 ; Vol. 85, No. 4. pp. 927-931.
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abstract = "Objective To present our operative approach and outcomes with buccal mucosal graft urethroplasty for anastomic stricture in the neophallus. Methods All patients who underwent buccal mucosal graft urethroplasty by a single surgeon for urethral stricture in a neophallus between March 1998 and June 2013 were identified. Urethroplasties were performed using 1-stage ventral onlay buccal mucosal graft after incision of the stricture. Results Ten patients were included in analysis. One patient underwent creation of neophallus after trauma, whereas all others were performed as gender reassignment. In all patients, strictures were located at the anastomosis between the native and the neourethra. Mean age was 39 years (range, 26-56 years). Mean stricture length was 3.6 cm (range, 2-6 cm). Median follow-up was 9.5 months (range, 2.7-84 months). At last follow-up, all the first 3 patients had stricture recurrence, whereas 5 of the next 7 patients remained free of stricture (overall success rate, 50{\%}). A total of 11 follow-up procedures were performed for recurrent strictures in these patients, including 8 internal urethrotomies, 1 suprapubic tube placement, and 2 repeat urethroplasties. The only perioperative complication was a patient who experienced mild rhabdomyolysis, which resolved with supportive measures. Conclusion Experience with urethral strictures in the neophallus is limited, and management is complex. Buccal mucosal graft urethroplasty may be more effective than endoscopic management, but failure remains common. Modifications in surgical approach and experience may improve outcomes.",
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N2 - Objective To present our operative approach and outcomes with buccal mucosal graft urethroplasty for anastomic stricture in the neophallus. Methods All patients who underwent buccal mucosal graft urethroplasty by a single surgeon for urethral stricture in a neophallus between March 1998 and June 2013 were identified. Urethroplasties were performed using 1-stage ventral onlay buccal mucosal graft after incision of the stricture. Results Ten patients were included in analysis. One patient underwent creation of neophallus after trauma, whereas all others were performed as gender reassignment. In all patients, strictures were located at the anastomosis between the native and the neourethra. Mean age was 39 years (range, 26-56 years). Mean stricture length was 3.6 cm (range, 2-6 cm). Median follow-up was 9.5 months (range, 2.7-84 months). At last follow-up, all the first 3 patients had stricture recurrence, whereas 5 of the next 7 patients remained free of stricture (overall success rate, 50%). A total of 11 follow-up procedures were performed for recurrent strictures in these patients, including 8 internal urethrotomies, 1 suprapubic tube placement, and 2 repeat urethroplasties. The only perioperative complication was a patient who experienced mild rhabdomyolysis, which resolved with supportive measures. Conclusion Experience with urethral strictures in the neophallus is limited, and management is complex. Buccal mucosal graft urethroplasty may be more effective than endoscopic management, but failure remains common. Modifications in surgical approach and experience may improve outcomes.

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