LAUSR

OBJECTIVE to describe dorsal onlay buccal mucosa graft (BMG) urethroplasty technique by subcoronal approach and glans preservation in distal penile urethral strictures with fossa navicularis involvement (DUS+FN) and to report safety, effectiveness and cosmetic outcomes. METHODS retrospective review of a prospective database of patients treated at Hospital Italiano de Buenos Aires between January 2011 - December 2019. Main surgical steps: ventral subcoronal incision, dorsal dissection of glandelar urethra until piercing the tip of the glans, dorsal urethrotomy and graft transposition. Low urinary tract symptoms, uroflowmetry and urinalysis were assessed at follow-up. Simplified International Index Erectile Function (IIEF-5) and Hypospadias Objective Scoring Evaluation (HOSE) were applied one year after surgery. RESULTS Sixteen patients with a median age of 56.5 years (IQR 35.7-66.7) were included. Median stricture length was 5.5 cm (IQR 4-8.7). In 3 patients, Clavien-Dindo grade I - II complications were reported. At one year, median peak flow was 18 ml/seg (IQR 12.7-27.4) and median mean flow 7.8 ml/seg (IQR 6.1-9.9). At 41.5 months follow-up (IQR 13.2-74) all patients were stricture free and had no changes in erectile function. HOSE score ≥ 14 points was achieved by 14 patients (87.5%). CONCLUSIONS for treatment of DUS+FN, dorsal onlay BMG by subcoronal approach and glans preservation is a feasible technique with excellent functional outcomes, minimal complications and substantial cosmetic results.