Urethral strictures of the navicular fossa, with or without involvement of the external urethral meatus, are typically treated using buccal mucosal grafts (BMG). Recently, minimally invasive transurethral urethroplasty techniques with BMG have been developed. However, in cases of obliterative strictures, a single BMG with limited urethral plate may be insufficient to create a patent urethra. In addition to using a dorsal BMG, pedicled penile skin flaps are often employed for coverage on the ventral side.
Here, we present an alternative surgical method utilizing a double-face BMG. We describe two cases of obliterative urethral strictures of the fossa navicularis – one involving the external urethral meatus. In both cases, a BMG was inserted using a "dorsal inlay" technique onto the distal corpora cavernosa and the dorsal surface of the spongy tissue of the glans penis, and it was quilted in place. A second BMG was then inserted from the ventral side, anastomosed to the native urethra, and fixed ventrally using the previously dissected glans wings. Glansplasty was performed over the ventral BMG to create a neomeatus.
Both patients showed no recurrence of the strictures during a 12-month follow-up period and expressed high satisfaction with the functional and aesthetic outcomes of the procedure. The use of double-face BMG for urethral augmentation is an effective surgical technique for treating obliterative urethral strictures of the navicular fossa.