AccScience Publishing / Bladder / Online First / DOI: 10.14440/bladder.2024.0063
RESEARCH ARTICLE

Buccal versus lingual mucosal grafts for anterior urethral stricture management: A prospective surgical outcome and morbidity comparison

Ahmed Moustafa Nafie1* Mahmoud Moustafa Nafie2 Ahmed Aosmali2 Basma Mohamed Soliman3
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1 Department of Urology, Frimley Park Hospital, Frimley, Surrey GU16 7UJ, England
2 Department of General Surgery, King’s College Hospital, London SE5 9RS, England
3 Department of Emergency, King’s College Hospital, London SE5 9RS, England
Submitted: 15 November 2024 | Revised: 17 February 2025 | Accepted: 21 March 2025 | Published: 5 May 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Background: Urethral stricture is characterized by long-term scarring and narrowing of the urethral canal caused by acute trauma, inflammation, or medical procedures, such as urethral instrumentation or surgery. Despite the widespread use of both buccal and lingual mucosal grafts (LMG) in urethroplasty, few prospective studies have directly compared their surgical outcomes and donor site morbidity. This study aims to fill that gap. Objective: This study compares the use of buccal and LMG in managing anterior urethral stricture with surgical outcomes and donor site morbidity evaluations. Methods: This case–control comparative study was conducted at Ain Shams University Hospital. Patients who attended the urology outpatient clinic, presenting with lower urinary tract symptoms secondary to stricture anterior urethra and underwent surgical management by urethroplasty with a dorsal onlay technique, were selected as cases. Results: No statistically significant differences were observed between the studied groups regarding age, smoking status, comorbidities, related urinary conditions, or the presence of a urinary catheter. In addition, the groups had no significant differences concerning stricture characteristics, graft details, or operation specifics. Similarly, general and urethral outcomes showed no statistically significant variation between the groups. Problems with drinking, soft food consumption, solid food consumption, dysgeusia, and speaking were significantly less frequent in the buccal mucosal graft (BMG) group than in the LMG group. In contrast, oral tightness was significantly more frequent in the BMG group than in the LMG group. Conclusion: The study concluded that buccal and LMG effectively repair anterior urethral stricture, showing similar success rates. However, LMG patients experience earlier oral complications, while BMG patients face more long-term oral tightness, making graft choice dependent on patient-specific tolerances.

Keywords
Anterior urethral stricture
Donor site morbidity
Buccal mucosal graft
Lingual mucosal graft
Oral complications
Stricture recurrence
Graft success
Funding
None.
Conflict of interest
The authors have no conflicts of interest to declare.
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