Histopathological Characteristics of Buccal Mucosa Transplants in Humans after Engraftment to the Urethra: A Prospective Study

Abstract

Buccal mucosa transplants retain their histopathological characteristics and are not overgrown with urothelium after urethral engraftment and urine exposure in humans. These findings may explain the superiority of buccal mucosa transplants on the outcome of substitution urethroplasty compared to that of other materials.

Update on managing anterior urethral strictures

“…[ 30 31 ] Oral mucosa contains many of the ideal graft characteristics for urethral reconstruction and therefore may be considered the gold standard for augmentation. [ 30 31 32 ] Oral mucosa is superior over the skin as a substitution material in both penile and bulbar urethral strictures. [ 33 34 ] One reason for its durability is that it retains its histopathological characteristics and is not overgrown with urothelium after urethral engraftment and urine exposure.…”

“…[ 33 34 ] One reason for its durability is that it retains its histopathological characteristics and is not overgrown with urothelium after urethral engraftment and urine exposure. [ 32 ] Compared to the bladder, rectum, and skin, it has a thick epithelium to provide durability and is less prone to contracture or sacculation. Furthermore, it has a thin lamina propria making it more receptive to expeditious neovascularization.…”

Urétroplastie avec greffe de muqueuse buccale : techniques de prélèvements et complications. Revue de la littérature et rapport d’un cas

“…Chez tous les patients, la muqueuse buccale conserve la totalité de ses caractéristiques histologiques, avec un épithélium pluristratifié. À la zone de jonction, il existe une barrière nette entre urothélium et épithélium de muqueuse buccale [17]. Il n'y a pas été retrouvé d'inflammation du tissu conjonctif sousjacent contrairement à l'étude animale de Souza et al [18].…”

Editorial Comment from Dr Goel to Total proximal ureter substitution using buccal mucosa

“…Soave et al . reported that the integrated buccal mucosa transplant completely preserved the histological characteristics of the oral mucosa in all patients, consisting of typically thick sheets of non‐keratinized squamous epithelium with a stratum spinosum . It is likely that the buccal graft in the retroperitoneum will behave in a similar fashion and retains its character.…”

“…Literature to answer these queries is scant. However, there are some studies that have studied the fate of buccal grafts placed during urethroplasty in both humans and animals . Soave et al .…”