Initial experience of buccal mucosa urethroplasty in Tanzania

Objective: To present the experience with the use of buccal mucosa graft urethroplasty.Patients and methods: This was a retrospective review of 53 consecutive patients who presented with urethral strictures seen by the author from January 2002 to December 2003 and were managed with different forms of urethral reconstruction.Results: Two thirds of the 53 patients were treated by end-to-end anastomosis. Seventeen patients (32.1%) had substitution urethroplasty. The causes of the strictures in the seventeen patients were infection in 7, catheter induced stricture in 6, and external trauma in 3 patients. One patient had Balanitis Xerotica Obliterans. The sites of the stricture were penile and bulbous in the majority of the patients. Out of the 17 patients, 13 had buccal mucosa graft (BMG) urethroplasty. Among these, ten were offered the procedure as a single stage while three patients had multistage reconstruction. Complications from the donor site were bleeding, pain and infection. The results of the grafts were good in 11 patients voiding with a good stream and a normal urethroscopy. Two patients had to have Direct Vision Urethrotomy (DVU) and one needed clean intermittent catheterization (CIC). The average follow up time was 18.5 months.Conclusion: The use of buccal mucosa for urethral reconstruction is recommended when faced with complex stricture. The procedure is well tolerated by patients and has few complications with good end result of an adaptable mucosa