Lingual Mucosal Graft Urethroplasty for Anterior Urethral Strictures

Das, S. N.; Kumar, Abhay; Sharma, Girish Kumar; Pandey, Avantika; Bansal, Harbans; Trivedi, Sameer; Dwivedi, US; Bhattacharya, V.; Singh, Priyanka

doi:10.1016/j.urology.2008.06.041

Cited by 56 publications

(42 citation statements)

References 16 publications

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“…After LMG urethroplasty was first described by Simonato et al [6] subsequent series have reported excellent outcomes after a short-and medium-term follow-up (Table 4) [6,10,11,16,17]. The present study specifically evaluated the outcomes of LMG urethroplasty over a prolonged follow-up.…”

Section: Discussionmentioning

confidence: 88%

86 Long Term Results of Lingual Mucosal Grafts for Repairing Long Anterior Urethral Strictures

Elgamal¹,

Farha²,

El-Abd³

et al. 2012

Journal of Urology

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Objective: To evaluate the long-term results of repairing long anterior urethral strictures with lingual mucosa onlay grafts.Patients and methods: This study included 23 patients (mean age 36.3 years, range 21-62) who had a lingual mucosa onlay graft for managing a long anterior urethral stricture, and who were followed up for P5 years. The mean length of the stricture was 4.6 cm. The International Prostate Symptom Score and uroflowmetry values were obtained before surgery, and at 3, 6 and 12 months afterwards, and annually thereafter. A retrograde urethrogram with a voiding cysto-urethrogram was taken before surgery, at catheter removal, after 3 and 6 months, and selectively thereafter.Results: The mean (range) follow-up was 66 (60-72) months. The cause of the stricture was trauma in nine patients, instrumentation in seven, idiopathic in four, urethritis in two and previous hypospadias repair in one. The surgery was successful in 20 of the 23 patients (87%), and a recurrent stricture developed in the remaining three. There were no fistulae or clinically perceptible graft sacculations, and no longterm donor-site complications.Conclusions: With a long-term follow-up, our series confirms the durability of lingual mucosal onlay grafts for treating long anterior urethral strictures. This

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Section: Discussionmentioning

confidence: 88%

86 Long Term Results of Lingual Mucosal Grafts for Repairing Long Anterior Urethral Strictures

Elgamal¹,

Farha²,

El-Abd³

et al. 2012

Journal of Urology

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“…Moreover, complications, such as recurrence, pain, swelling and oral opening limitation, often occur during the long-term follow-up. 8 Tissue engineering is an effective method to solve these tough problems. [9][10][11] In animal experiments, cell-seeded scaffolds have been successfully used to repair longer urethral defections in rabbit model.…”

Section: Discussionmentioning

confidence: 99%

Preliminary experimental study of urethral reconstruction with tissue engineering and RNA interference techniques

Li¹,

Xu²,

Li³

2013

Asian J Androl

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This study investigated the feasibility of replacing urinary epithelial cells with oral keratinocytes and transforming growth factor-b1 (TGF-b1) small interfering RNA (siRNA)-transfected fibroblasts seeded on bladder acellular matrix graft (BAMG) in order to reconstruct tissue-engineered urethra. Constructed siRNAs, which expressed plasmids targeting TGF-b1, were transfected into rabbit fibroblasts. The effective siRNA was screened out by RT-PCR and was transfected into rabbit fibroblasts again. Synthesis of type I collagen in culture medium was measured by enzyme-linked immuno sorbent assay (ELISA). Autologous oral keratinocytes and TGF-b1 siRNA-transfected fibroblasts were seeded onto BAMGs to obtain a tissue-engineered mucosa. The tissue-engineered mucosa was assessed morphologically and with the help of scanning electron microscopy. The TGF-b1 siRNA decreased the expression of fibroblasts synthesis type I collagen. Oral keratinocytes and TGF-b1 siRNA-transfected fibroblasts were seeded onto sterilized BAMG to obtain a tissue-engineered mucosa for urethral reconstruction. The compound graft was assessed using scanning electron microscope. Oral keratinocytes and TGF-b1 siRNA-transfected fibroblasts had a good compatibility with BAMG. The downregulation of fibroblasts synthesis type I collagen expression by constructed siRNA interfering TGF-b1 provided a potential basis for genetic therapy of urethral scar. Oral keratinocytes and TGF-b1 siRNA-transfected fibroblasts had good compatibility with BAMG and the compound graft could be a new choice for urethral reconstruction.

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“…However, buccal mucosa may not be suitable for treating long complicated urethral strictures because of limited material [18]. Lingual mucosal graft urethroplasty is a good substitute for buccal mucosal graft urethroplasty with equally good results of urethroplasty with lower donor-site morbidity [23,24,25,26]. However, it has the same shortcomings as buccal mucosal graft urethroplasty.…”

Section: Discussionmentioning

confidence: 99%

Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

Liu

et al. 2012

Urol Int

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Objective: To determine the feasibility and effectivity of allogenic frozen-thawed bladder mucosa for urethroplasty. Methods: Bladder mucosa was harvested from 6 New Zealand rabbits. Changes in the bladder mucosa as seen by histological and electron microscope examination were compared between the frozen-thawed and fresh groups. Twelve urethral stricture models were established and randomly divided into two groups. In the test group, we performed urethroplasty with allogenic frozen-thawed bladder mucosa, and the same operation was done in the control group, but using fresh bladder mucosa. The result of retrograde urethrography and histological changes of the urethral sample were compared postoperatively. Results: No obvious changes on histological and electron microscope examination were observed in the frozen-thawed bladder mucosa. Inflammation reaction of the surgical site in the test group was milder than that of the controls 2 weeks after surgery. The urethral epithelial cells grew well 2 weeks after surgery, but lots of epithelia were necrotic in the control group. The urethra of all rabbits in the test group had good continuity and the urethral lumen was large in the test group 2 months after surgery. There was a layer of urethral epithelium in the test group 2 months after surgery, whereas scar tissue was found in the control group. Conclusions: The freeze-thaw technique can maintain bladder mucosa structure and biological function. Frozen-thawed allogenic bladder mucosa may be a potential material for urethroplasty.

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Lingual Mucosal Graft Urethroplasty for Anterior Urethral Strictures

Cited by 56 publications

References 16 publications

86 Long Term Results of Lingual Mucosal Grafts for Repairing Long Anterior Urethral Strictures

86 Long Term Results of Lingual Mucosal Grafts for Repairing Long Anterior Urethral Strictures

Preliminary experimental study of urethral reconstruction with tissue engineering and RNA interference techniques

Urethral Reconstruction Using Allogenic Frozen-Thawed Bladder Mucosa: An Experimental Study

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