Buccal versus lingual mucosal graft in management of anterior urethral stricture: a prospective comparison of surgical outcome and donor site morbidity

Objective: The aim of the study is to compare between the use of buccal mucosal graft and lingual mucosal graft in management of anterior urethral stricture with evaluation of surgical outcome and donor site morbidity. Methods: This is a case control comparative study, was carried out at Ain Shams university hospital. All cases were selected from those attending the urology outpatient clinic presenting with lower urinary tract symptoms secondary to stricture anterior urethra and prepared for surgical management by urethroplasty with dorsal onlay technique. Results: There was no statistically significant difference between the studied groups regarding age, smoking, comorbidities, associated urinary condition and having urinary catheter. There was no statistically significant difference between the studied groups regarding stricture, graft and operation characteristics. There was no statistically significant difference between the studied groups regarding general and urethral outcomes. Problems with drinking (day-3), problems with eating soft food (day-3), problems with eating solid food (day-3 and week-2), dysgeusia (day-3 and week-2) and speaking problems (day-3, week-2 and month-6) were significantly less frequent in BMG group. Oral tightness (day-3, week-2 and month-6) was significantly more frequent in BMG group. Conclusion: As evident from the current study, the study concluded that both buccal mucosal graft (BMG) and lingual mucosal graft (LMG) are effective options for the surgical management of anterior urethral strictures. The surgical outcomes, including graft success, stricture recurrence, and urethral function, were similar between the two groups. However, significant differences were observed in donor site morbidity. Patients in the LMG group experienced more early postoperative complications related to oral functions, such as difficulties with drinking, eating, and speaking. On the other hand, BMG patients reported more long-term issues with oral tightness. These findings suggest that both grafts are suitable for urethral stricture repair, but the choice of graft may depend on individual patient circumstances, particularly regarding their tolerance for specific oral complications.