Dorsal versus ventral onlay buccal mucosal graft urethroplasty for long-segment bulbar urethral stricture: A prospective randomized study

ObjectivesTo compare safety and efficacy of ventral versus dorsal onlay buccal mucosal graft urethroplasty in patients with long-segment incomplete bulbar urethral stricture. MethodsThis was a single center, prospective, randomized trial. Patients with long-segment (>2cm) incomplete bulbar urethral stricture and meeting eligibility criteria were enrolled in the study. They were randomized into two study groups: group A undergoing dorsal onlay buccal mucosal graft urethroplasty and group B undergoing ventral onlay buccal mucosal graft urethroplasty. The two groups were compared statistically with regard to International Prostate Symptom Score, maximum flow rate, intraoperative parameters and complications. ResultsA total of 80 eligible patients were randomized into two equal groups of 40 patients each. The preoperative International Prostate Symptom Score, maximum flow rate and intraoperative parameters were not significantly different between the two groups. At 12-month follow up, the mean International Prostate Symptom Score showed 324.95% and 353.59% improvement, whereas the mean maximum flow rate showed 208.43% and 201.93% improvement in groupA and B, respectively. There was no significant difference between International Prostate Symptom Score and maximum flow rate data between the two groups at 3- and 12-month follow up. The success rate of surgery was similar between groupA and B (92.5% vs 90%) with no significant difference noted between them. ConclusionDorsal and ventral onlay buccal mucosal graft urethroplasty have comparable efficacy and complication rates for treatment of long-segment incomplete bulbar urethral strictures.