Buccal Mucosal Graft Urethroplasty

Buccal Mucosa Graft Urethroplasty in India: Procedure and Recovery

The full name for BMG urethroplasty is buccal mucosa graft urethroplasty. The buccal mucosa is the cheek’s inner lining. For longer urethral strictures, tissue transfer is performed using a graft or flap.

Urethral strictures are a rare illness. It includes scarring, which makes it difficult to excrete pee from the body. The scarring constricts the urine-carrying channel. Urinary stricture may be caused by inherited factors, medicinal treatments, or trauma. Long bulbar or penile urethral strictures are classified as complicated strictures requiring repair.

If the urethral stricture is lengthy, it may be necessary to reconstruct it using various tissues. Surgeons remove the oral mucosa transplant to heal the strictures. Urethroplasty has used buccal mucosa graft tissues since the 1990s because they are hairless and easily accessible. Furthermore, no one can see the scar within the mouth or on the lower lip.

What are the indications for Buccal Mucosa Urethroplasty?

The doctor may diagnose urethral stricture. Then your doctor may suggest a buccal mucosa transplant urethroplasty. The most obvious sign of urethral stricture is a weakened urine system. Symptoms are:

• Urination problems
• discomfort when urinating
• A urinary tract infection
• Prostatitis

Some persons have severe urethral strictures and are unable to pee. Urinary retention is the phrase used for this. It’s a medical emergency. Urine may also return to the kidneys if the bladder is not emptying properly. This might lead to hydronephrosis. That might lead to kidney failure.

Urinary strictures may cause prostate inflammation. The prostate is placed directly underneath the bladder. It encircles the urethra. The word “prostatitis” refers to prostate inflammation. Urine backlog may lead to serious urinary tract infections. Antibiotics and urethral stricture treatment may help treat them.

What is the surgical procedure for BMG urethroplasty?

Let’s talk about the Buccal Mucosa Graft Urethroplasty stages.

Every patient had a single-stage transperineal repair with urethroplasty. A buccal transplant is used to treat their long urethral stricture.

• Step 1: The surgeon makes a circumcisional incision. It occurs when the patient is in the lithotomy position. It is performed under general anaesthesia. Then he creates a perineal incision and slices the midline of the perineum. It introduces him to the penis.
• Step 2: The surgeon separates the corpus spongiosum and corpora cavernosa. This stretches it from the penis’ glans to the sphincter.
• Step 3: The surgeon cuts the urethral stricture along its dorsal side. It takes one or two cheeks to harvest the buccal transplant. This has a maximum length and breadth of 1.5 to 2cm.
• Step 4: To minimize dead areas, doctors thinned the grafts. The grafts are located on the dorsal section of the urethra. They are attached to the corpora cavernosa’s tunica albuginea. It makes use of numerous 5-0 vicryl sutures.
• Step 5: Surgeons stitch the incised urethral borders. It is applied to the rims of the buccal transplant using an 18F silicon catheter. In this method, they retubulate the urethra.
• Step 6: After the drain placement, the penile skin returns to its natural position. The perineum is similarly organized into anatomical layers.

Patients are placed on bed rest for four to six days. The medical staff then enables the patients to quit bed rest after 72 hours.

Follow-up: The medical team keeps the urethral catheter for 21 days. They do retrograde urethrography after the third week. For any subsequent leaks, the medical staff retains the urethral catheter in place for 14 days. Otherwise, they will remove it at that moment.

During the first year, patients get follow-up appointments every three months. Later, they plan appointments every six months or in the event of an emergency. The medical team undertakes extensive testing. Urine culture comes next. They then conduct a complete analysis at each follow-up session. It concludes with a detailed history-taking.