Joshi's Step With Buccal Mucosal Graft Urethroplasty in Nearly Obliterated Bulbar Urethral Stricture

NCT ID: NCT07088198

Last Updated: 2025-07-28

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-05-01
• Study Completion Date: 2025-11-01

Brief Summary

This study aims to evaluate the functional and surgical outcome of Joshi's step with buccal graft urethroplasty for the management of nearly obliterated bulbar urethral stricture.

Detailed Description

Urethroplasty is a rapidly evolving art that continually improves and reinvents itself. After a century of silence, during which the anastomotic repair was the only solution for approaching the strictured urethra, the 1990s can be considered the Renaissance period for reconstructive urology.

In 2022, Joshi and Kulkarni introduced a new step to the augmented urethroplasty, particularly in patients with extremely narrow strictures where a single augmentation was insufficient. They avoid any resection of the residual native urethral plate, marking the narrowest portion. Then, the edges of the mucosa are reapproximated with interrupted suturing in a proper non-resecting approach.

Conditions

Joshi's Step; Buccal Mucosal Graft; Urethroplasty; Obliterated Bulbar Urethral Stricture

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Study group

Patients will undergo dorsal onlay buccal mucosal graft urethroplasty with Joshi's step

Group Type: EXPERIMENTAL

Joshi's step

Intervention Type: PROCEDURE

Patients will undergo dorsal onlay buccal mucosal graft urethroplasty with Joshi's step

Interventions

Joshi's step

Patients will undergo dorsal onlay buccal mucosal graft urethroplasty with Joshi's step

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients with primary bulbar urethral stricture.
• Patients with non-traumatic bulbar urethral stricture.
• Patients with nearly obliterated bulbar urethral stricture, with the narrowest portion of the stricture is less than 1.5 cm in length.

Exclusion Criteria

• Patients with traumatic bulbar urethral stricture.
• Patients with redo bulbar urethral stricture.
• Patients with obliterated bulbar urethral stricture.
• Patients with nearly obliterated long bulbar urethral stricture.

• Minimum Eligible Age: 18 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

Tanta University

OTHER

Sponsor Role: lead

Responsible Party

Mohamed Ibrahim Ahmed Elmaadawy

Lecturer of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Tanta University

Tanta, El-Gharbia, Egypt

Site Status: RECRUITING

Countries

Egypt

Central Contacts

Mohamed I Elmaadawy, MD

Role: CONTACT

Mohamed.elmaadawy@med.tanta.edu.eg

00201060245430

Facility Contacts

Mohamed I Elmaadawy, MD

Role: primary

Mohamed.elmaadawy@med.tanta.edu.eg

00201060245430

Other Identifiers

36264PR661/4/24

Identifier Type: -

Identifier Source: org_study_id