Efficacy and Safety of Double‐Face Buccal Mucosa Graft Urethroplasty for Obliterative or Near‐Obliterative Anterior Urethral Stricture: A Systematic Review and Single‐Arm Meta‐Analysis

Purpose To systematically evaluate the success rate and safety of double‐face buccal mucosa graft (BMG) urethroplasty for the treatment of obliterative or near‐obliterative anterior urethral strictures. Methods A systematic literature search was conducted in accordance with the PRISMA guidelines across PubMed, Web of Science, Embase, and the Cochrane Library for studies published up to October 2025. Studies reporting the surgical success rate were included. The risk of bias was assessed using the ROBINS‐I tool. A single‐arm meta‐analysis was performed using Stata 15 to calculate the pooled success rate and its 95% confidence interval (CI). Heterogeneity was assessed using the I 2 statistic. Sensitivity analysis was performed to test the robustness of the results when significant heterogeneity was detected. Publication bias was assessed using funnel plots and Egger’s test. Results A total of ten single‐arm studies comprising 511 patients who underwent double‐face BMG urethroplasty for obliterative or near‐obliterative anterior urethral strictures were included. Quality assessment using the ROBINS‐I tool rated all studies as having a moderate overall risk of bias. The pooled surgical success rate was 89% (95% CI: 0.86–0.92, p < 0.001), with no significant heterogeneity observed across studies ( I 2 = 0% and p = 0.97). Sensitivity analysis confirmed the stability of this pooled estimate. Assessment of publication bias revealed a symmetric funnel plot and a nonsignificant Egger’s test result ( p = 0.109), suggesting low risk of publication bias. Conclusion Double‐face BMG urethroplasty demonstrates a high pooled success rate of 89% with low heterogeneity across studies, confirming its effectiveness for treating obliterative or near‐obliterative anterior urethral strictures. As a nontransecting single‐stage option, it should be reserved as a last‐resort reconstructive strategy for complex cases where excision and primary anastomosis is not feasible and unilateral augmentation alone cannot create an adequate lumen due to a severely compromised urethral plate.