Multi-Institutional Experience With Buccal Mucosa Onlay Urethroplasty for Bulbar Urethral Reconstruction

Kane, Christopher J.; Tarman, Gregory J.; Summerton, Duncan J.; Buchmann, Craig E.; Ward, John F.; O’Reilly, Keith J.; Ruiz, Henry; Thrasher, J. Brantley; Zorn, Burk; Smith, Carolyn; Morey, Allen F.

doi:10.1097/00005392-200203000-00024

Cited by 31 publications

(40 citation statements)

References 19 publications

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“…[3,34] Furthermore, the natural moist location of the buccal mucosa in the oral environment favors its easy adaptability in the urethral passage when used as a free graft. [35,36] The mucous membranes of the cheek and lower lip receive their nerve supply from the buccal and mental branches of the mandibular nerve, respectively.…”

Section: Buccal and Labial Mucosaementioning

confidence: 99%

“…[8,9] Some authors have recommended buccal mucosa over flaps for patch urethroplasty. [10,11] Buccal mucosa takes shorter time to harvest compared with penile flaps and spares the penis from potential complications of scarring (donor site), torsion and cordee. The chances of failure and recurrence are reduced in patients with balanitis xerotica obliterans as buccal mucosa is not involved in this process.…”

Section: Introductionmentioning

confidence: 99%

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Oral mucosa grafts for urethral reconstruction

Mungadi

Ugboko

2009

Ann Afr Med

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Background: Urethral reconstruction has continued to present formidable and enormous challenges for urologic, paediatric and plastic surgeons as diverse opinions have been expressed on the quality and type of ideal substitution material. This literature review is aimed at drawing attention of surgeons to the versatile nature of oral mucosal grafts. Methods: A review of the utilization of oral mucosa in urethral reconstruction was made. Structured Medline search was performed looking at all aspects of utilization of oral mucosa including mucosal harvest, donor site morbidity and outcome. Results: The unique demands of the urethra set a high standard for autogenous graft substitutes; hence literature reports reveal that split and full thickness skin grafts from the scrotum, penis, extragenital sites (ureter, saphenous vein, appendix, colon, medial upper arm, neck, lateral chest, abdomen, bladder mucosa) and more recently oral mucosa have been used. Unlike other tissues, oral mucosa grafts are fl exible, easy to harvest and trim and have an excellent microvasculature favorable for graft-taking. Furthermore, the natural moist location of the oral mucosa in the oral environment favours its easy adaptability in the urethral passage thus giving good long-term results. However, there are reports of complications at the donor site with the commonest being anaesthesia or paraesthesia of the cheek or lips. Regional variations of the oral mucosa, length of the graft required, the decision to close or leave donor site open and harvesting technique are some of the factors suggested to account for differences in donor site morbidity. Conclusion: Oral mucosal graft is a versatile urethral substitute with excellent outcome. It is becoming the gold standard for urethral substitution.

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Section: Buccal and Labial Mucosaementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral mucosa grafts for urethral reconstruction

Mungadi

Ugboko

2009

Ann Afr Med

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“…Traditionally urethroplasty is performed as an ventral onlay , with the corpus spongiosum either excised and reconstructed using a buccal mucosal patch applied to a dorsal native urethral roof strip or incised in the midline over the stricture to perform a ventral stricturotomy, 8,9 with the free graft applied to augment the urethra. Ideally, the corpus spongiosum is then closed over the graft to provide a well-vascularised bed, and the bulbocavernosus muscle and soft tissues are then closed to complete the procedure.…”

Section: Bulbar Urethramentioning

confidence: 99%

Surgical Techniques in Substitution Urethroplasty Using Buccal Mucosa for the Treatment of Anterior Urethral Strictures

2008

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IntroductionSince the resurgence in the use of buccal mucosa in substitution urethroplasty in the late 1980s and early 1990s, there has been controversy as to which surgical technique is the most appropriate for its application. MethodThe authors performed a literature review. Several centres have published widely on this topic, and the points considered include the use buccal mucosa (BM) in dorsal-onlay grafts, ventral-onlay grafts, tubularised grafts and the role of two-stage procedures. ResultsIn experienced hands, the outcomes of both dorsal-onlay grafts and ventral-onlay grafts in bulbar urethroplasty are very similar. The dorsal-onlay technique is however possibly less dependent on surgical expertise and therefore more suitable for surgeons new to the practice of urethroplasty. The complications associated with ventral-onlay techniques can be minimised by meticulous surgical technique, but in series with longer follow-up still tend to be more prevalent.In penile urethroplasty, two-stage dorsal onlay of BM (after complete excision of the scarred urethra) still provides the best results, although in certain circumstances a onestage dorsal-onlay procedure is possible. In general, ventral-onlay of BM and tube graft procedures in the management of penile strictures are associated with much higher rates of recurrence and should therefore be avoided. ConclusionsIn experienced hands the results of the ventral and dorsal-onlay of BM for bulbar urethroplasty are equivalent. Two-stage procedures are preferable in the penile urethra, except under certain circumstances when one-stage dorsal-onlay is feasible.

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“…7,24,25 Fakat, bazı darlıklar çok kısadır ve HMS yapılmasını mümkün kılmaktadır. 12 Lumen ve ark., 1 cm'den küçük darlığı bulunan 10 hastaya HMS operasyonu uygulanması sonrası ortalama 46,6 ay izlem süresinde %90 başarı oranı bildirmişlerdir.…”

Section: Discussionunclassified

Comparison of Heineke Mikulicz Stricturoplasty and End to End Anastomotic Urethroplasty Techniques for Short Bulbar Urethral Strictures

Şimşek¹,

Şam²,

Ekşi³

et al. 2017

J Reconstr Urol

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Multi-Institutional Experience With Buccal Mucosa Onlay Urethroplasty for Bulbar Urethral Reconstruction

Abstract: Buccal mucosa grafts used as a ventral onlay for bulbar urethral reconstruction yield reproducibly excellent results with minimal morbidity and low complication rates. Longer followup will be required to confirm the durability of our results.

Cited by 31 publications

References 19 publications

Oral mucosa grafts for urethral reconstruction

Oral mucosa grafts for urethral reconstruction

Surgical Techniques in Substitution Urethroplasty Using Buccal Mucosa for the Treatment of Anterior Urethral Strictures

Comparison of Heineke Mikulicz Stricturoplasty and End to End Anastomotic Urethroplasty Techniques for Short Bulbar Urethral Strictures

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