Postauricular Skin Grafts in The Treatment of Bulbar Urethral Stricture Disease
Abstract:
Introduction: Chewing of tobacco or consumption of betel nut and pan masala results in several alterations in the oral cavity, making harvesting of healthy buccal mucosa next to impossible. In such patients with a long bulbar urethral stricture, the selection of the substitute material for urethral reconstruction is a challenge. The objective of our study was to assess the feasibility and efficacy of post-auricular skin in the repair of such strictures and also to assess the outcome of such repairs 12 months later. Materials and Methods: All male patients with long segment bulbar urethral strictures were prospectively included in the study. Patients who were either circumcised or had unhealthy genital skin and whose oral mucosa was significantly damaged by the incessant use of tobacco and other substances were offered an option to undergo urethroplasty using post-auricular skin. Results: During the study period a total of 22 patients with long segment bulbar urethral strictures underwent substitution urethroplasty using post-auricular skin grafts. The mean length of the stricturous segment was 5.84+1.29 cms. The mean operative time was 135.23+12,58 mins and the mean blood loss was 120 cc. Following catheter removal all patients voided with a good urinary stream (mean Q max was 22.41±2.63 ml/sec). Conclusion: Post-auricular skin is an acceptable alternative material for urethral reconstruction in patients having a long-segment bulbar urethral stricture with neither a healthy buccal mucosa or genital skin for harvesting a graft.
