ABSTRACT Urethral stricture is a common urological condition often managed with buccal mucosal graft urethroplasty (BMGU), using either dorsal BMGU (DOBMGU) or ventral onlay BMGU (VOBMGU) techniques. The comparative efficacy and safety of these approaches remain unclear. To compare the clinical outcomes of DOBMGU and VOBMGU in treating anterior urethral stricture through a systematic review and meta-analysis. Fourteen studies (one randomized controlled trial, two prospective cohort, seven retrospective cohorts, and four case series) involving 970 patients (496 DOBMGU and 474 VOBMGU) were included. Meta-analysis was performed using odds ratios (OR) and mean differences with a random-effects model. Success rates were comparable (DOBMGU 87.1%, VOBMGU 86.9%; OR 1.03; 95% confidence interval CI: 0.70–1.52; P = 0.88). DOBMGU showed superior improvement in Qmax (MD: 3.23 mL/s; 95% CI: 0.73–5.73; P = 0.01), while the operative time was longer (MD: 11.28 min; 95% CI: 4.04–18.52; P = 0.002). Blood loss and complication rates, including fistula, infection, hematoma, and postmicturition dribbling, were similar. Both DOBMGU and VOBMGU yield comparable success and safety profiles. DOBMGU may offer improved functional outcomes but requires a longer operative duration. Technique selection should be tailored to stricture characteristics and surgical expertise.
Ibrahim et al. (Thu,) studied this question.
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