Buccal Mucosa Graft for Ureteral Stricture Substitution: Initial Experience

OBJECTIVES To evaluate the use of buccal mucosa tubal graft for reconstruction of extensive ureteral stricture. MATERIALS AND METHODS Between April 2006 and July 2008, 5 patients (mean age, 51.2 years) underwent reconstructive ureteral surgery for ureteral obstruction using buccal mucosa graft. The indication of surgery was extensive ureteral stricture of a 4.4-cm average length (range, 3.5-5.0). The site of stricture was in the proximal and the middle ureter in 3 and 2 patients, respectively. The causes of stricture were postinflammatory (3 cases) and iatrogenic after ureteroscopic procedures for impacted stones (2 cases). RESULTS All 5 patients underwent successful ureteral defect replacement using buccal mucosal tube. The intraoperative course was uneventful without any major complications. Mean operative time was 106 minutes (range, 85-130). With a mean follow-up of 24 months (range, 14-39), the operated kidneys showed no obstruction. CONCLUSIONS Oral buccal mucosal tubal graft for reconstruction of extensive ureteral stricture is a good available option. Although the results of this initial experience are encouraging, a bigger series and longer follow-up is recommended to evaluate our procedure. UROLOGY 76: 971-976, 2010. (C) 2010 Published by Elsevier Inc.