Urethroplasty for distal penile strictures using buccal mucosal graft (BMG), historically, have been carried out in a two stages with an interval of 6 months. There is 10% chance of revision due to cross-fibrosis. We present results for single stage distal penile urethroplasty performed solely for BXO strictures

A single stage distal penile urethroplasty was performed on 27 patients. Five had previous failed repair. Urethra was closed over a 14F. Follow up was at 6 weeks, 3 months and then 6 monthly for 2 years with urethroscopy, flow rate and post void residuals (PVR). Recurrence was described as on endoscopy.

All patients had BXO induced distal penile stricture with previous dilatation and ISD. The mean follow-up time was 42.5months (range=10-78 months). The average stricture length was 5.3 cm (range 1.5-12cm). Four out of 27 patients suffered recurrence of their strictures (14.8%). Small urethral fistula developed in 14.8% of patients (4/27). Other complications included persistent graft-site pain (n=1), penile haematoma (n=1) and 1 patient had recurrent UTI. Standard flowmetry showed an average improvement in patient Qmax from 9.1 to 20.6 ml/sec (p<0.005) and a drop of the average PVR from 30mls to 15 mls.

Our results show that single stage distal penile urethroplasty with buccal mucosal grafting is a successful and safe procedure even in low volume centres.

This study suggests that single stage BMG urethroplasty for BXO induced distal penile strictures is safe and effective as a first line surgical option. Failure rates are at comparable with 2-staged one and patients benefit from a single hospital stay and a shorter overall recovery/treatment period.