Dorsal onlay buccal mucosal graft urethroplasty in inflammatory stricture of urethra - Our experience

Urethral stricture is a common disease with changing etiology and changing practices in management. Management options were grossly determined by cause, site, length of stricture and also by other factors like prior attempts of repair and local genital skin condition. Treatment options vary from dilatation, optical urethrotomy to various types of urethroplasty. Substitution urtethroplasty is done using various types of graft materials like skin, buccal mucosa, bladder mucosa or colonic mucosa. Over the past 10-15 years buccal mucosa grafts have been increasingly used in the urethral reconstruction. Barbagli technique (Dorsal onlay technique) has the advantages of no sacculation which is seen with ventral onlay grafts, good neovascularity and less shrinkage (10%) rate. We have presented the results and complications of doral onlay buccal mucosa graft urethroplasty (Barbagli technique) in 20 cases performed over a period of 30 months in our institution. Our study showed a success rate of 80% at the end of 2yrs follow up, comparable with other studies, with a restructure rate of 20%. None of our patients developed urethrocutaneous fistula and urethral diverticulum.