Urethral Stricture: A Comparison Between Jugal or Labial Graft Urethroplasty
Study Details
Study Description
Brief Summary
Buccal mucosa urethroplasty is a current fashion in urethral stricture management. In our university centre (Hospital de Clínicas de Porto Alegre) is a common surgical treatment choice. This paper aims to evaluate the success rate of this treatment after randomized choice between labial and jugal (inner cheek) grafts during the past two years.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Free dorsal graft urethroplasty, first described by Barbagli et al, has been shown better results than ventral grafts. Fixed grafts on the corpora cavernosa results in a better mechanical support and vascular supply, with less chance to complications such as pseudodiverticula and sacculations either a better urethral phisiology.
This study aims to evaluate the current surgical management in our centre: buccal mucosa graft urethroplasty with jugal or labial replacement, comparing their group success rate and complications between the groups in patients led to surgery from October 2016 to June 2018.
Prospective analysis from urethral stricture surgical HCPA patient data by dorsal buccal mucosa graft urethroplasty. The graft choice were done by a software. Longer stricture with transoperative need for the two grafts use were excluded. Success rate were measured with a no stricture de novo or absence of complications in a six month interval.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Labial Patients who received a labial graft as replacement of urethral tissue |
Procedure: Labial Graft
As replacement of the damaged urethral tissue, we used a buccal mucosa graft (labial graft).
|
| Active Comparator: Jugal Patients who received a jugal (inner cheek) graft as replacement of urethral tissue |
Procedure: Jugal Graft
As replacement of the damaged urethral tissue, we used a buccal mucosa graft(inner cheek - jugal graft).
|
Outcome Measures
Primary Outcome Measures
- Overall Success Rate [6 months]
Absence of surgical intervention after prior surgery
- Labial Group Success Rate [6 months]
Absence of surgical intervention after prior surgery on patients who received a labial graft.
- Jugal Group Success Rate [6 months]
Absence of surgical intervention after prior surgery on patients who received a inner cheek graft.
- Latex Catheter Success Rate [6 months]
Absence of surgical intervention on patients who used a latex catheter indwelling after prior surgery.
- Silicon Catheter Success Rate [6 months]
Absence of surgical intervention on patients who used a silicon catheter indwelling after prior surgery.
Secondary Outcome Measures
- Stricture Etiology [24 months]
Evaluation of the etiology of the stricture (trauma, other, infectious) on patients included on Labial and Jugal Groups
- Stricture Localization [24 months]
Evaluation of the stricture localization (penile, bulbar/bulbomembranous or combined) on patients included on Labial and Jugal Groups
- Stricture Size [24 months]
Evaluation of the stricture length (cm) on patients included on Labial and Jugal Groups
- Demographic Data [24 months]
Evaluation of the demographic data relationship with the results (age, cystotomy, cystostomy time, tobacco use, diabetes, balanitis xerotica, UTI infection, serum creatin levels) included on Labial and Jugal groups
Eligibility Criteria
Criteria
Inclusion Criteria:
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Urethral Stricture Diagnosis
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Indication for buccal mucosa graft urethroplasty
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Accept the Informed Consent Term (patient or responsible)
Exclusion Criteria:
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Severe urethral stricture which a two-staged procedure are required
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Long strictures which need a both types of buccal mucosa graft due its length.
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Refuse to ICT for the patient ou it responsible
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Hospital de Clinicas de Porto Alegre
- Federal University of Rio Grande do Sul
Investigators
- Principal Investigator: Brasil S Neto, Phd MD, Hospital de Clinicas de Porto Alegre
Study Documents (Full-Text)
None provided.More Information
Publications
- Akyüz M, Güneş M, Koca O, Sertkaya Z, Kanberoğlu H, Karaman Mİ. Evaluation of intraoral complications of buccal mucosa graft in augmentation urethroplasty. Turk J Urol. 2014 Sep;40(3):156-60. doi: 10.5152/tud.2014.46343.
- Aldaqadossi H, El Gamal S, El-Nadey M, El Gamal O, Radwan M, Gaber M. Dorsal onlay (Barbagli technique) versus dorsal inlay (Asopa technique) buccal mucosal graft urethroplasty for anterior urethral stricture: a prospective randomized study. Int J Urol. 2014 Feb;21(2):185-8. doi: 10.1111/iju.12235. Epub 2013 Aug 12.
- Asopa HS, Garg M, Singhal GG, Singh L, Asopa J, Nischal A. Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach. Urology. 2001 Nov;58(5):657-9.
- Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique? J Urol. 2005 Sep;174(3):955-7; discussion 957-8.
- Barbagli G, Palminteri E, Lazzeri M, Guazzoni G, Turini D. Long-term outcome of urethroplasty after failed urethrotomy versus primary repair. J Urol. 2001 Jun;165(6 Pt 1):1918-9.
- Barbagli G, Pellegrini G, Corradini F, Montorsi F, Sansalone S, Butnaru D, Lazzeri M. One-stage Penile Urethroplasty Using Oral Mucosal Graft and Glue. Eur Urol. 2016 Dec;70(6):1069-1075. doi: 10.1016/j.eururo.2016.04.025. Epub 2016 May 6.
- Barbagli G, Vallasciani S, Romano G, Fabbri F, Guazzoni G, Lazzeri M. Morbidity of oral mucosa graft harvesting from a single cheek. Eur Urol. 2010 Jul;58(1):33-41. doi: 10.1016/j.eururo.2010.01.012. Epub 2010 Jan 19.
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- Palminteri E, Lumen N, Berdondini E, Di Pierro GB, Cucchiarale G, Tenti G, De Nunzio C. Two-sided dorsal plus ventral oral graft bulbar urethroplasty: long-term results and predictive factors. Urology. 2015 Apr;85(4):942-7. doi: 10.1016/j.urology.2015.01.013.
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- Sharma AK, Chandrashekar R, Keshavamurthy R, Nelvigi GG, Kamath AJ, Sharma S, Venkatesh GK. Lingual versus buccal mucosa graft urethroplasty for anterior urethral stricture: a prospective comparative analysis. Int J Urol. 2013 Dec;20(12):1199-203. doi: 10.1111/iju.12158. Epub 2013 Apr 21.
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