Tubularised Buccal Mucosal Graft Urethroplasty for Posterior Pelvic Fracture Urethral Distraction Defects in Children

Objective: Posterior urethral trauma is rare type of trauma that is particularly difficult to treat in children. Here, we have presented our experience with tubularised buccal mucosal graft (BMG) repairs for posterior pelvic fracture urethral distraction defects (PFUDDs) in children. Material and Methods: We retrospectively evaluated three cases of tubularised BMG repairs for PFUDDs in our clinic between 2009 and 2016. The BMGs were 3 cm in length, on average, and sutured between the stump of the proximal prostatic urethra and the distal bulbar urethra. All of the patients underwent urethrography, urethroscopy and uroflowmetry assessments postoperatively. Results: The mean patient age was 9 (6–14) years and all three patients were male. Two of the three patients with posterior urethral injuries were operated on at least twice at another centre and referred to our clinic with PFUDDs. All three patients underwent tubularised BMG urethroplasties for the PFUDDs. We noted urethral integrity in the cystoscopic evaluations of two of the patients, with no strictures, and these two patients were fully continent. A proximal anastomotic contracture was noted in the third patient and a revision was required. Conclusion: A tubularised BMG should be used to prevent penile shortening and anastomotic tension in a PFUDD