Assessment of the perfusion and morbidity of the buccal mucosal donor site for grafting of urethral strictures

Hölzle, Frank; Mitchell, David A.; Rau, Andrea; Palisaar, Jüri; Loeffelbein, Denys J.; Noldus, Joachim; Hoheisel, Anne; Mücke, Thomas; Kesting, Marco; Wolff, Klaus‐Dietrich

doi:10.1016/j.jcms.2010.12.004

Cited by 25 publications

(13 citation statements)

References 26 publications

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“…Buccal mucosa and internal preputial grafts share many advantages, such as a strong anti-infection ability, rich capillary beds, high survival rates, and abundant graft sources (Bapat et al 2007 ; Holzle et al 2012 ; Iselin and Webster 1998 ). Therefore, these grafts can be ideal candidates for urethral tissue in reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Selecting the right method for hypospadias repair to achieve optimal results for the primary situation

Shuzhu

Yidong

et al. 2016

SpringerPlus

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Background Over the past two decades, Snodgrass tubularized incised plate (TIP) urethroplasty has become one of the dominant surgical techniques with wide applications and excellent cosmetic results. However, TIP has many limitations. We performed a retrospective study at our department and assessed the outcome of the inlay internal preputial graft for extending the applications of TIP.MethodsBetween January 2009 and December 2013, we performed a retrospective study consisting of approximately 508 primary distal and moderate cases. Patients with primary distal hypospadias who had mild or no chordee and good penile development were divided into the following 3 groups based on their procedures: (1) classic TIP hypospadias repair group (n = 198); (2) inlay buccal mucosa graft group (n = 150); and (3) inlay internal preputial graft group (n = 160). The median age was 1.6 years (range 1–4 years). Our data were analyzed statistically by the Chi square test with P < 0.05 indicating significant differences. ResultsThe mean follow-up period was 18 months (range 6‒24 months). In the classic TIP group, the incidence of urinary fistula and meatal stenosis were both 3.0 % (6/198); in the inlay buccal mucosal graft group, the incidence of urinary fistula was 3.3 % (5/150), and the incidence of stenosis was 2.7 % (4/150); and in the inlay internal preputial graft group, the incidence of urinary fistula was 3.1 % (5/160), and the incidence of meatal stenosis was 4.4 % (7/160). The success rates of each group were as follows: the classic TIP group has a success rate of 93.9 % (186/198); the inlay buccal mucosa graft group had a success rate of 94.0 % (141/150); and the inlay internal preputial graft group had a success rate of 92.5 % (148/160). There were no statistically significant differences between the 3 groups with respect to complication rates.ConclusionsAs the inner foreskin Snodgraft does not appear to be worse than the buccal mucosa graft, it is a good method for hypospadias repair, and this method is not inferior to TIP.

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Section: Discussionmentioning

confidence: 99%

Selecting the right method for hypospadias repair to achieve optimal results for the primary situation

Shuzhu

Yidong

et al. 2016

SpringerPlus

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“…Our search yielded 1,275 records. After removal of duplicates, we screened the titles and abstracts of 590 records, excluded 564 and then screened 26 full-text articles of which we excluded 15 references [ 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 ], which did not meet our inclusion criteria; see PRISMA flowchart ( Fig. 1 ) for further details.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Randomized Controlled Trials Comparing Buccal Mucosal Graft Harvest Site Non-Closure versus Closure in Patients Undergoing Urethral Reconstruction

Hwang

Fazio

Hamilton

et al. 2022

World J Mens Health

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Purpose To assess the effects of buccal mucosal graft site non-closure versus closure on postoperative oral morbidity for male undergoing augmentation urethroplasty for urethral stricture. Materials and Methods We included randomized controlled trials. Inclusion criteria were male over the age of 18 with urethral stricture disease requiring reconstruction with buccal mucosal graft harvest. Primary outcomes of the review were postoperative oral pain, need for secondary oral procedures and cosmetic defects. Results We included 5 studies with 346 randomized patients with urethral strictures, of whom 260 completed the trials. In terms of primary outcomes, non-closure graft site may reduce oral pain on postoperative day #1 (standard mean difference [SMD] 0.24 lower; 95% confidence interval [CI] 0.61 lower to 0.12 higher; low certainty evidence [CoE]) but we are uncertain how this impacts pain on postoperative days 3 to 6 (SMD 0.35; 95% CI 0.12 to 0.81 higher; very low CoE). We are also very uncertain as to how it affects the need for secondary oral procedures (risk ratio [RR] 0.22; 95% CI 0.01 to 4.28; very low CoE). Non-closure may increase the risk of cosmetic defects (RR 2.40; 95% CI 0.93 to 6.22; low CoE). Conclusions This review describes the trade-off for buccal mucosal graft site non-closure versus closure for various patient-important outcomes; decision-making will likely hinge on the relative value individual patients and surgeons place on them. The supporting evidence was rated as low and very low, thereby signaling substantial underlying uncertainty and the need for better trials.

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“…With the advantages of buccal mucosa grafts such as ease of harvest, quality of substrate, and low complication rates, this treatment has become more popular in the repair of hypospadias [17]. Hairless, highly-vascularized lamina propria and non-keratinized epithelium of buccal mucosa provide excellent substrates for the reconstruction [18]. The use of buccal mucosa grafts in children with proximal hypospadias was first reported by Burger et al in 1992 [19] and has gradually been popularized.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Adjuvant Hyperbaric Oxygen Therapy in Adults who Underwent Hypospadias Surgery

Kara¹

2017

Ann Clin Anal Med

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Amaç: Hipospadias tedavisi amacıyla bukkal mukoza ile tüp üretroplasti yapılan erişkin hastalarda hiperbarik oksijen tedavisi (HBO2T)'nin rolünü değerlendirmek. Gereç ve Yöntem: Çalışmaya hipospadiası olan 16 erişkin hasta dahil edildi. Kısa üretra ve penil kurvaturu olan hastalar iki aşamalı tedavi edildi (ortoplasti+bukkal mukoza ile tüp üretroplasti). Tüp üretroplasti için alınan mukoza 16 Fr. nelaton kateter etrafında tübülarize edilerek üretral mea ile glans penis arasına yerleştirildi. Hastaların 13'üne ameliyat sonrası birinci günden itibaren hafta içi günlerde toplam 10 seans HBO2T uygulandi. Bulgular: Hastaların ortalama hasta yaşı 21(±1,23) ve takip süresi 10.1(±2.1) aydı. HBO2T uygulanan 13 hastanın 6(%46)'sinde iki aşamalı (ortoplasti+bukkal tüp mukoza grefti) onarım gerçekleştirildi ve ortalama greft uzunluğu 5.4(±1,23) cm idi. Bu gruptaki hastalarda hipospadias ameliyatı sonrası %54(7/13) oranında başarı sağlanırken, ikincil işlem (internal üretrotomi ve/veya fistül onarımı) sonrası başarı oranı %84.6 (11/13) olarak izlendi. HBO2T uygulanmayan 3 hastanın 1(%33)'inde iki aşamalı onarım gerçekleştirildi ve ortalama greft uzunluğu 8(±5) cm idi. Bu gruptaki hastalarda hipospadias ameliyatı sonrası başarı sağlanamazken ikincil işlem sonrası başarı oranı %33(1/3) olarak izlendi. Tartışma: Hiperbarik oksijen tedavisinin bukkal mukoza ile tüp uretroplasti cerrahisiyle kombine edilmesi başarıyı arttırmaktadır. Bu konuda daha geniş, prospektif çalışmalara ihtiyaç vardır.

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Assessment of the perfusion and morbidity of the buccal mucosal donor site for grafting of urethral strictures

Cited by 25 publications

References 26 publications

Selecting the right method for hypospadias repair to achieve optimal results for the primary situation

Selecting the right method for hypospadias repair to achieve optimal results for the primary situation

A Systematic Review of Randomized Controlled Trials Comparing Buccal Mucosal Graft Harvest Site Non-Closure versus Closure in Patients Undergoing Urethral Reconstruction

The Effectiveness of Adjuvant Hyperbaric Oxygen Therapy in Adults who Underwent Hypospadias Surgery

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