To review the success rate of ventral onlay buccal mucosal grafts for anterior bulbar urethroplasty in patients who had undergone multiple procedures before repair.

We performed a retrospective review of one surgeon’s experience performing 58 consecutive buccal mucosal urethroplasties on 57 patients from September 1999 to September 2004. The cause of the anterior urethral stricture was unknown in 33, trauma in 20, and urethritis in 4. Most of these patients had undergone multiple procedures before urethroplasty. An American Urological Association symptom score questionnaire was sent to all patients.

The average patient age was 40.7 years (range 17 to 72). The average follow-up was 29.6 months (range 6 to 66). Of the 57 patients, 48 responded to the American Urological Association questionnaire (84%), and the average symptom and bother score was 4.8 and 1.3, respectively. Three patients had treatment failure, for a 94% success rate.

The results of this study confirm the efficacy of buccal mucosal urethroplasty for anterior urethral strictures, especially in a tertiary referral setting in which a number of our patients had undergone repeat endoscopic procedures and multiple urethral dilations.