The long-term results of lingual mucosal grafts for repairing long anterior urethral strictures

Objective: To evaluate the long-term results of repairing long anterior urethral strictures with lingual mucosa onlay grafts. Patients and methods: This study included 23 patients (mean age 36.3 years, range 21–62) who had a lingual mucosa onlay graft for managing a long anterior urethral stricture, and who were followed up for ≥ 5 years. The mean length of the stricture was 4.6 cm. The International Prostate Symptom Score and uroflowmetry values were obtained before surgery, and at 3, 6 and 12 months afterwards, and annually thereafter. A retrograde urethrogram with a voiding cysto-urethrogram was taken before surgery, at catheter removal, after 3 and 6 months, and selectively thereafter. Results: The mean (range) follow-up was 66 (60–72) months. The cause of the stricture was trauma in nine patients, instrumentation in seven, idiopathic in four, urethritis in two and previous hypospadias repair in one. The surgery was successful in 20 of the 23 patients (87%), and a recurrent stricture developed in the remaining three. There were no fistulae or clinically perceptible graft sacculations, and no longterm donor-site complications. Conclusions: With a long-term follow-up, our series confirms the durability of lingual mucosal onlay grafts for treating long anterior urethral strictures. This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.