To compare the results of conventional dorsal graft versus combined (dorsal plus ventral) graft urethroplasty for isolated pendulous urethral strictures a retrospective analysis of prospectively maintained data was done. Currently, the optimal treatment of pendulous urethral stricture is unknown, although buccal mucosal graft urethroplasty, with the graft placed either dorsally or ventrally, is a feasible repair option.

Between August 2004 and January 2010, adult men suitable for 1-stage repair were randomized (alternate case) to either group 1 (dorsal only) or 2 (combined). Dorsal graft placement was done by Asopa's technique, whereas in the combined method, another strip of mucosa was placed ventrally. Parameters measured were etiology and length of stricture, operating time, complications, and outcomes.

Twenty men participated in the study (10 in each group). The groups were similar (P = NS) in age (mean in years, group 1: 35.3 and group 2: 38.7), etiology, and length of stricture (mean in cm, group 1: 7.2 and group 2: 7.5). The mean operating time was 102 (group 1) and 131 minutes (group 2) (P ≤.05). The complications were minor and comparable between groups. At mean follow-up of 35.7 (group 1) and 31.8 (group 2) months, 7 and 8 men had successful outcomes. The major limitation is the small number of patients and short follow-up.

Comparable short-term results were achieved in both groups. We suggest that if the space is inadequate dorsally, then combined graft placement is another option.