The Use of Lingual Mucosal Graft in Adult Anterior Urethroplasty: Surgical Steps and Short-Term Outcome

Oral Mucosa Graft: An Ideal Substitute for Urethroplasty

“…The overall early stricture recurrence was 20.7%. (27) Since then a number of groups have investigated the feasibility of lingual mucosa graft urethroplasty (16, 17, 21-23, 25, 26, 29, 30, 36, 47) whether experimentally (17,21) or clinically, (16,22,23,25,26,29,30,36,47) alone or with buccal mucosa, (16,17) and with different urethroplasty techniques. (23,26,47) Barbagli et al (25) later described their early experience using LMG for urethral reconstruction in 10 patients with anterior urethral strictures.…”

“…(20) Barbagli et al (25) similarly described graft harvesting from the ventral surface of the tongue, suggesting that, when necessary, two grafts can be harvested from the same ventral tongue site. (25) In our description of the technique we suggested taking the graft from the lateral and undersurface of the tongue between the papillae situated on the dorsum and the sublingual mucosa. (29) (Fig.…”

“…(36) In Barbagli's experience, the length of the lingual grafts was 4-6 cm (mean: 4.5 cm) with a width of 2.5 cm. (25) In our study, the length of the LMG used ranged from 4-10 cm and a width of 1.5 cm. (Fig.…”

“…1 However, there is more bleeding associated with the lingual graft because the tongue is more vascular than the cheek. (25) During graft harvesting, care should be taken to the site of the opening of Wharton's duct and the underlying lingual nerve. Simonato et al (20) reported the lateral mucosal lining of the tongue as the harvest graft site since it is identical to the lining of the rest of the oral cavity and has no particular functional features.…”

“…The junction between the graft and the normal urethra was discernible by its gross appearance, and the LMGs were tightly incorporated into the urethral walls. (21) Since then, numerous reports for the use of the lingual mucosa for urethroplasty were published in the last 5 years (16,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)) emphasizing Simonato's conclusion that the mucosa of the tongue is a safe and effective graft material in the armamentarium for urethral reconstruction with potential minor risks of donor site complications. (27) …”