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• W2010321350 abstract "No AccessJournal of UrologyAdult Urology1 Dec 2014Histopathological Characteristics of Buccal Mucosa Transplants in Humans after Engraftment to the Urethra: A Prospective Study Armin Soave, Stefan Steurer, Roland Dahlem, Michael Rink, Philipp Reiss, Margit Fisch, and Oliver Engel Armin SoaveArmin Soave Equal study contribution. More articles by this author , Stefan SteurerStefan Steurer Equal study contribution. More articles by this author , Roland DahlemRoland Dahlem More articles by this author , Michael RinkMichael Rink More articles by this author , Philipp ReissPhilipp Reiss More articles by this author , Margit FischMargit Fisch More articles by this author , and Oliver EngelOliver Engel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.06.089AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Histopathological changes in buccal mucosa transplants after engraftment to the urethra and exposure to urine remain nebulous. We investigated histopathological changes in buccal mucosa transplants integrated into the urethra in humans. Materials and Methods: We prospectively evaluated 22 patients with recurrent urethral stricture after buccal mucosa urethroplasty between November 2012 and October 2013. All patients underwent repeat buccal mucosa urethroplasty performed by a single surgeon. Intraoperatively we harvested a sample of the integrated buccal mucosa transplant previously engrafted to the urethra, a sample of healthy urethra, a sample of freshly harvested buccal mucosa from the contralateral inner cheek and a sample of fibrotic tissue from the area of the current stricture. A dedicated uropathologist performed meticulous histopathological examination of all tissue samples using hematoxylin and eosin staining. Preoperative clinical data were also collected on all patients. Results: The mean interval from previous to current buccal mucosa urethroplasty was 22.2 months (range 4.1 to 76.0). Mean stricture length at repeat urethroplasty was 52.7 mm (range 30.0 to 70.0). Histopathological characteristics of the integrated buccal mucosa transplants were completely preserved in all patients, consisting of thick sheets of stratified nonkeratinized squamous epithelium with a stratum spinosum. Transplants were not partially or entirely overgrown with urothelium. Conclusions: 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. References 1 : Current management of urethral stricture. Korean J Urol2013; 54: 561. Google Scholar 2 : Tunica vaginalis onlay urethroplasty as a salvage repair. J Urol1999; 162: 1146. Link, Google Scholar 3 : Single-stage preputial skin flap urethroplasty for long-segment urethral strictures: evaluation and determinants of success. BJU Int2014; 113: 120. 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Google Scholar 19 : The buccal mucosa fenestrated graft for Bracka first stage urethroplasty: experimental study in rabbits. Int Braz J Urol2012; 38: 825. Google Scholar 20 : Anastomotic fibrous ring as cause of stricture recurrence after bulbar onlay graft urethroplasty. J Urol2006; 176: 614. Link, Google Scholar 21 : Histologic changes after urethroplasty using small intestinal submucosa unseeded with cells in rabbits with injured urethra. Urology2013; 81: 1380.e1. Google Scholar 22 : [Urethroplasty with tissue matrix. Microsurgical animal experiments with small intestinal submucosa]. Urologe A2007; 46: 1236. Google Scholar 23 : Dorsal tunica vaginalis graft plus onlay preputial island flap urethroplasty: Experimental study in rabbits. J Pediatr Urol2009; 5: 93. Google Scholar 24 : The tunica vaginalis dorsal graft urethroplasty: experimental study in rabbits. J Urol2005; 174: 765. 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Link, Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByKurtzman J, Sukumar S, Pan S, Mendonca S, Lai Y, Pagan C and Brandes S (2021) The Impact of Preoperative Oral Health on Buccal Mucosa Graft HistologyJournal of Urology, VOL. 206, NO. 3, (655-661), Online publication date: 1-Sep-2021.Viers B, Pagliara T, Shakir N, Rew C, Folgosa-Cooley L, Scott J and Morey A (2017) Delayed Reconstruction of Bulbar Urethral Strictures is Associated with Multiple Interventions, Longer Strictures and More Complex RepairsJournal of Urology, VOL. 199, NO. 2, (515-521), Online publication date: 1-Feb-2018.Vetterlein M, Stahlberg J, Zumstein V, Engel O, Dahlem R, Fisch M, Rosenbaum C and Kluth L (2018) The Impact of Surgical Sequence on Stricture Recurrence after Anterior 1-Stage Buccal Mucosal Graft Urethroplasty: Comparative Effectiveness of Initial, Repeat and Secondary ProceduresJournal of Urology, VOL. 200, NO. 6, (1308-1314), Online publication date: 1-Dec-2018. Volume 192Issue 6December 2014Page: 1725-1729 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordsreoperationurethral strictureautograftshistologymouth mucosaMetricsAuthor Information Armin Soave Equal study contribution. More articles by this author Stefan Steurer Equal study contribution. More articles by this author Roland Dahlem More articles by this author Michael Rink More articles by this author Philipp Reiss More articles by this author Margit Fisch More articles by this author Oliver Engel More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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