✦ Urethral Stricture Treatment

BMG Urethroplasty (Buccal Mucosa Graft)

Q: Will my cheek be affected after graft harvest?

Mild tightness and numbness in the cheek is common for 2–4 weeks; long-term donor site morbidity is minimal in most patients.

Q: How long is recovery from BMG urethroplasty?

The urethral catheter remains for 3–6 weeks; full recovery including return to work takes 4–6 weeks. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: Is BMG urethroplasty a one-stage procedure?

Yes, most patients complete treatment in one stage; staged procedures are reserved for severely scarred or failed reconstructions. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Graft Urethroplasty Using Buccal Mucosa for Long or Complex Strictures

120–180 min PROCEDURE

3–4 Days HOSPITAL STAY

>85% SUCCESS RATE

4–6 Weeks RECOVERY

What is BMG Urethroplasty (Buccal Mucosa Graft)?

BMG Urethroplasty uses a graft of buccal mucosa (inner cheek lining) to reconstruct the urethral lumen in patients with long, complex, or panurethral strictures not amenable to EPA. The graft is inlaid or onlaid onto the urethral plate to augment the lumen. Buccal mucosa is the preferred graft material due to its excellent blood supply, resilience to the wet urethral environment, and durability. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–4 Days. Success rates reach >85% in appropriately selected patients at experienced centres.

Patients with long (>2 cm) bulbar or penile strictures, complex or recurrent strictures, or those where EPA is not feasible. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Positioning & Perineal Access

Under general anaesthesia, patient positioned in exaggerated lithotomy; perineal dissection through midline or inverted-U incision with splitting of the bulbospongiosus muscle.

Stricture Identification

The strictured urethra is opened along its ventral or dorsal surface; the urethral plate assessed for augmentation.

Buccal Mucosa Harvest

Buccal mucosal graft harvested from the inner cheek; graft defatted on a board under loupe magnification.

Graft Application

For dorsal onlay (Barbagli) approach: the urethra is rotated and the graft sutured to the corpora cavernosa dorsally, then the urethral plate closed over it.

Closure & Catheter

Bulbospongiosus muscle re-approximated over the urethroplasty; catheter left for 3–6 weeks; oral donor site heals by secondary intention.

Outcomes

120–180 minDURATION

3–4 DaysHOSPITAL STAY

>85%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Buccal mucosa is the preferred graft material in urethroplasty — resilient, well-vascularised, tolerant of the wet urethral environment.
→BMG urethroplasty achieves long-term success rates of 80–90% at 5 years for bulbar strictures.
→The oral harvest site heals rapidly by secondary intention with minimal long-term morbidity.
→The dorsal onlay graft position places the buccal mucosa on the well-vascularised corporal surface.
→In panurethral stricture disease, combined anterior and posterior graft techniques restore the entire urethra.
→Two to four weeks of catheterisation after BMG urethroplasty allows graft take and anastomosis healing.

"BMG urethroplasty using buccal mucosa has revolutionised the management of complex strictures. Buccal mucosa is the ideal biological material for urethral reconstruction — durable, resilient, and universally available."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Will my cheek be affected after graft harvest?+

How long is recovery from BMG urethroplasty?+

Is BMG urethroplasty a one-stage procedure?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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