Bulbar Urethroplasty +/- Buccal Mucosa Graft Augmentation is a reconstructive procedure performed to treat strictures of the bulbar urethra that are too long or complex for excision and primary anastomosis. The technique involves harvesting a graft of buccal mucosa (inner cheek lining), which is sutured into the urethra to widen the narrowed segment.
The buccal graft provides a durable, well-vascularised tissue substitute and is typically placed dorsally or ventrally onto the opened urethra, depending on stricture characteristics. This approach is commonly used for strictures that have failed prior minimally invasive endoscopic treatments.
If stricture length and anatomy are favourable, a graft may not be required, and a non-transecting anastomotic approach can be performed instead—preserving the bulbar arteries and maintaining urethral vascular integrity.
Due to the tailored nature of reconstruction and the potential need for graft harvest, the procedure requires specialist surgical expertise. Buccal graft donor sites are closed with absorbable sutures, and patients can resume oral intake immediately after surgery.
Post-operative care includes a structured recovery protocol. The urethral catheter is removed after a peri-catheter urethrogram confirms satisfactory healing. Surgical success is assessed at 3 months with a follow-up urethrogram.
