Buccal urethroplasty: 2020 literature review update

Introduction. We have analyzed the world experience of using buccal graft as a relatively safe and effective method of surgical treatment of extensive ureteral strictures. Materials and methods. The review was conducted on the basis of data published in the PubMed databases, the Elibrary.ru Scientific Electronic Library and on the websites of professional urological associations. At the first stage, 107 sources were found, of which 35 articles were included in the review. Results. We identified 21 original studies with buccal graft for ureteroplasty, among them open surgery was applied in 13 studies, robotic in 6 studies and laparoscopic in 2 studies. A total of buccal ureteroplasty using all three approaches was performed 96 times for 94 patients (such an operation was performed on both ureters for two patients). The open operation was applied in 55 cases in 53 patients with an average ureteral stricture length of 5.8 cm (2.5-15.0 cm). After open surgery, recovery of normal ureteral patency was recorded in 94.5% (52/55) of cases for an average follow-up period of 28 months (3-85 months). Robotic technique was used in 39 patients with an average ureteral stricture length of 3.8 cm (1.5-8.0 cm). The success of treatment after robotic operations was achieved in 89.7% (35/39) cases for an average follow-up period of 20 months (3.5-44 months). Laparoscopic technique was used only in two patients, and postoperative follow-up was 1 and 9 months, respectively. No stricture recurrence was noted during this period. All variants of operations were associated with a minimal risk of early and late postoperative complications. Conclusions. Buccal ureteroplasty can be regarded as an advantageous alternative to severe and associated with a high incidence of complications surgery (replacement intestinal ureter, autotransplantation of the kidney, etc.), used for long ureteral stricture.