Balanitis Xerotica Obliterans: An experience with Buccal Mucosa Onlay Flap Graft.

Background: Balanitis Xerotic obliterans (BXO) or Penile Lichen Sclerosus is a dermatological condition affecting the genitalia and associated with chronic, progressive, sclerosing inflammatory dermatosis of unclear etiology. It was first described by Stuhmer in 1928, as being a rare condition but causes severe tissue destruction and often causes meatal stenosis and urethral stricture. Our objective is to present the experience of treatment of urethral stricture caused by Balanitis Xerotic Obliterans in our hospitals.
Methods: Between 2003 and 2008 eighteen patients with LUTS caused by BXO were referred to our hospitals for management. All patients were adults with the age range from 17 to 84 years. One of the patients had diabetes mellitus. Three patients presented with retention of urine, four had difficulty in passing urine and two patients presented with painful erection. One of the patients who had retention of urine presented with “ watering cane” perineum due to fistula and sinuses as a complication of long standing unattended stricture. The majority of the patients had strictures confined to the distal urethra and meatus. Six patients were treated with buccal mucosa onlay graft while one patient was offered for perineal urethrotomy.
Results: A total of eighteen (18) patients were attended, two patients were lost to follow up while 5 patients had a mean follow up of 22 months ranging from 8 to 60 months. Fifteen patients are reporting good progress while one patient is being treated with clean intermittent self catheterization and dilatation.
Conclusion: BXO is a rare cause of urethral stricture in our institution and buccal mucosa graft offers satisfactory intermediate term results.