Multistage Reconstruction of the Anterior Urethra Using Buccal Grafts in the Treatment of Post-Traumatic Injuries Resulting from Combat Trauma
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective. To evaluate the clinical efficacy and safety of multistage anterior urethral reconstruction using buccal grafts in the treatment of complex post-traumatic injuries resulting from combat trauma.Materials and Methods. A retrospective, two-center study was conducted based on an analysis of treatment outcomes in 14 patients with post-traumatic strictures and defects of the anterior urethra resulting from bullet, shrapnel, or blast injuries. The injuries were localized in the penile segment of the urethra in 8 patients and in the bulbous segment in 6. All patients underwent a multi-stage reconstruction using free buccal mucosal grafts. In 9 patients, a classic two-stage approach was used; in 5, an additional intermediate stage of urethral bed modification was performed due to scarring. In 3 patients, a vascularized flap from the scrotal tunica albuginea was used to provide multilayered protection of the suture line. Functional outcomes were assessed using uroflowmetry, and postoperative complications were classified according to the Clavien–Dindo classification.Results. All patients regained spontaneous urination, and the need for permanent suprapubic urinary diversion was eliminated. One patient voluntarily declined the final stage of tubularization, opting instead for a functioning perineostomy. Urethral fistulas developed in 3 patients: in 2, they were treated conservatively; in 1 patient, surgical correction was required. No recurrences of strictures, urinary incontinence, or de novo erectile dysfunction were recorded.Conclusions. Multistage urethroplasty using buccal grafts is an effective and safe method for treating complex post-traumatic injuries of the anterior urethra resulting from combat trauma. The number of reconstruction stages should be determined on a case-by-case basis according to the condition of the local tissues.
Authors: A. A. Kobirnichenko, V. V. Bondarchuk
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7203948141