One-stage urethral reconstruction using colonic mucosa graft: an experimental and clinical study

Xu, Yuhong; Ye, Qiao; Yang, Sa; Zhang, Jiong; Zhang, Huizhen; Zhang, Xinru; Wu, Denglong; Chen, Rong

doi:10.3748/wjg.v9.i2.381

Cited by 24 publications

(13 citation statements)

References 20 publications

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“…Complications, such as graft necrosis, meatal stenosis, stricture, and fistula formation, are common in these procedures. Furthermore, some recent research using small intestine or colon mucosa for urethral reconstruction have shown good results [5][6][7]. However, in spite of satisfying reconstruction outcomes in the patients, they are subjected to potential complications of abdominal surgery.…”

Section: Discussionmentioning

confidence: 98%

Urethral reconstruction using autologous and everted vein graft: an experimental study

et al. 2006

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Urethral reconstruction is one of the problematic issues in pediatric surgery. To evaluate the efficacy of vein graft for urethral reconstruction in rabbits, about 3 cm of distal urethra was excised under microscopic magnification. In groups A, B, and D, the urethra was replaced with the internal jugular vein. In group B, before performing anastomosis, vein grafts were everted. In group C (control group) after removing the urethra, a catheter was inserted without substituting the urethra and then fixed. Groups A, B, and C were kept for 3 months. Group D was divided into five subgroups each consists of two rabbits, which were killed at days 7, 10, 14, 22, and 30 for evolutionary histopathological studies. Gross evaluation, retrograde urethrography, and histopathological studies were also performed in other groups. Retrograde urethrography and gross evaluation revealed no sign of stricture and fistula formation in six and eight rabbits in groups A and B, respectively. However, those complications were observed in all the rabbits in group C. The grafted part of the neourethra was epithelialized with uroepithelium in all rabbits in group A (vein graft) and group B (everted vein graft) but only partial epithelialization was observed in three rabbits of group C. Severe fibrosis with stricture formation was developed in six rabbits in the control group. In group D, epithelialization gradually replaced necrosis and inflammation, within 1 month. This study showed that vein, everted or not, can be used as a substitute for urethra. It also suggests that new epithelialization might be formed from ingrowing of the uroepithelium from the proximal part.

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Section: Discussionmentioning

confidence: 98%

Urethral reconstruction using autologous and everted vein graft: an experimental study

et al. 2006

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“…[1] Reports show that split and full-thickness skin grafts from the scrotum, penis and extragenital sites (ureter, saphenous vein, appendix, colonic mucosa, medial upper arm, neck, lateral chest and abdomen), bladder mucosa and, more recently, oral mucosa have been used. [2][3][4][5][6] Skin provides abundant material that is easy to harvest, but its keratinized epithelium and split-thickness depth increase susceptibility to postoperative contracture, stricture formation and graft thickening when tabularized. [6] The skin hair also constitutes a major problem when hairy skin is used as a graft for urethral reconstruction.…”

Section: Introductionmentioning

confidence: 99%

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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“…Urethral substitution with intestinal segment has been used in congenital urethral anomalies [24,25]. Experimental use of colonic graft has also been reported [26]. Our experience shows that nearly 60% of recurrent strictures in children cannot be managed by anastomotic urethroplasty ( Table 2).…”

Section: Redo Casesmentioning

confidence: 67%

Traumatic strictures of the posterior urethra in boys with special reference to recurrent strictures

Aggarwal

Sinha

Kumar

et al. 2011

Journal of Pediatric Urology

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One-stage urethral reconstruction using colonic mucosa graft: an experimental and clinical study

Cited by 24 publications

References 20 publications

Urethral reconstruction using autologous and everted vein graft: an experimental study

Urethral reconstruction using autologous and everted vein graft: an experimental study

Oral mucosa grafts for urethral reconstruction

Traumatic strictures of the posterior urethra in boys with special reference to recurrent strictures

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