Dlouhodobé výsledky uretroplastik s použitím bukální sliznice v různých modifikacích

Long-term Results of Uretroplastic Operations Using Buccal Mucosa in Different Modifications

Backround.
Evaluation of long-term results of uretroplastic using buckle mucosa indicated in long and multiple strictures or after reconstruction of hypospadies is presented. 

Methods and Results.
49 cases of uretroplastic with buccal mucosa graft were performed. 28 patients had complicated strictures after multiple endoscopic or reconstructive operations. Onlay uretroplastic was performed in 35 cases, including ventral graft placing in first 8 patients, afterwards dorsal grafts were performed in 27 patients. In 6 cases whole circumference of urethra was replaced in two steps. The length of buccal graft varied between 30 and 80 mm, aprox. 63 mm, duplex graft was used in 3 cases in max. length of 140 mm. In follow-up on an average 45 months (3–140 months) it has occurred 6 recurrences of stricture; the need of open reoperation was in 3 patients (12.3 %), 2 relative restrictures were solved by optic urethrotomy (4 %). The reoccurrences appeared after ventral onlay in 2 cases (25%), after the dorsal onlay also in two cases (7,4 %), after two-steps uretroplastic there was 20 % (2 cases) of the reoccurrence rate. Duplex graft uretrolastics were in all cases without complications. Fistula has not occurred. All stricture recurrences were detected in period of 15 months. 

Conclusions.
Buccal mucosa graft uretroplastic is long-lasting effectiveness method with low complication rate, especially in dorsal graft placing. Complication rate does not cohere with the length of graft, uretroplastic extent, nor stricture localization. 

Key words:
uretroplastic, buccal mucosa, graft.