Buccal versus lingual mucosal grafts for anterior urethral stricture management: A prospective surgical outcome and morbidity comparison

Background: Urethral stricture is characterized by long-term scarring and narrowing of the urethral canal caused by acute trauma, inflammation, or medical procedures, such as urethral instrumentation or surgery. Despite the widespread use of both buccal and lingual mucosal grafts (LMG) in urethroplasty, few prospective studies have directly compared their surgical outcomes and donor site morbidity. This study aims to fill that gap. Objective: This study compares the use of buccal and LMG in managing anterior urethral stricture with surgical outcomes and donor site morbidity evaluations. Methods: This case–control comparative study was conducted at Ain Shams University Hospital. Patients who attended the urology outpatient clinic, presenting with lower urinary tract symptoms secondary to stricture anterior urethra and underwent surgical management by urethroplasty with a dorsal onlay technique, were selected as cases. Results: No statistically significant differences were observed between the studied groups regarding age, smoking status, comorbidities, related urinary conditions, or the presence of a urinary catheter. In addition, the groups had no significant differences concerning stricture characteristics, graft details, or operation specifics. Similarly, general and urethral outcomes showed no statistically significant variation between the groups. Problems with drinking, soft food consumption, solid food consumption, dysgeusia, and speaking were significantly less frequent in the buccal mucosal graft (BMG) group than in the LMG group. In contrast, oral tightness was significantly more frequent in the BMG group than in the LMG group. Conclusion: The study concluded that buccal and LMG effectively repair anterior urethral stricture, showing similar success rates. However, LMG patients experience earlier oral complications, while BMG patients face more long-term oral tightness, making graft choice dependent on patient-specific tolerances.