Experts assess pre-operative factors linked with buccal mucosa graft failure

A recent study presented at the 2025 American Urological Association Annual Meeting looked at pre-operative factors that may predict failure of robotic ureteroplasty with buccal mucosa graft (RU-BMG) for long ureteral strictures.¹ In a recent interview with Urology Times®, lead author Sonam Saxena detailed the background and key findings from this analysis.

Saxena explained, “Given the documented success of this treatment and the increasing adoption of this procedure, we wanted to explore if there's any ways to better tailor patient selection and analyze our large multi-institutional database for any pre-operative patient characteristics that might be predicting failure for the small cohort of patients that do fail this procedure.”

Saxena is a research fellow at Hackensack University Medical Center in New Jersey.

In total, the investigators assessed outcomes in 172 patients who underwent RU-BMG. The overall success rate was 91% with a mean follow-up of 33 months (range, 9 to 51).

The investigators found that only prior abdominal surgery was linked with an increased risk of failure for RU-BMG (P = .002). The authors reported, “Other pre-operative factors including history of smoking, prior ureteral stricture intervention, cardiovascular disease, diabetes mellitus, Crohn’s disease, prior abdominal radiation exposure, and the location, length, or etiology of the stricture did not predict surgical failure.”

During the discussion, Saxena noted that there is room for future study, given that their failure cohort only included 16 patients.

“We want to explore the reason that these patients are significantly more at risk of failure if they have a prior abdominal surgery. Maybe our sample size of failures just wasn't large enough, so we hope to build on this for the future,” she concluded.

REFERENCE

1. Saxena S, Gelman S, Lembrikova K, et al. Analysis of factors contributing to long-term failure of buccal mucosa graft for ureteroplasty - collaborative of reconstructive robotic ureteral surgery. J Urol. 2025;213(5S):e939. doi:10.1097/01.JU.0001110044.51006.b4.08