Autologous Buccal Mucosa Graft for Hypospadias Repair: An Initial Report

Dessanti, Antonio; Rigamonti, Waifro; Merulla, Vittorio; Falchetti, Diego; Caccia, G

doi:10.1016/s0022-5347(17)37478-5

Cited by 183 publications

(67 citation statements)

References 10 publications

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“…tates opening the bladder. Skin grafts and bladder mucosal grafts tend to stenose when brought to the Others [6][7][8][9][10] have described a combined total of 21 have used the labial buccal mucosa as a tube graft with less than satisfactory results, but still feel it is more suitable than its alternative, the bladder mucosa.…”

Section: Discussionmentioning

confidence: 99%

Buccal mucosal graft for secondary hypospadias repair and urethral replacement

Ahmed

Gough

1997

British Journal of Urology

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Objective To assess the effectiveness of buccal mucosa in the treatment of complex hypospadias Patients and methods Seventeen patients had an onlay patch of buccal mucosa to reconstruct the urethra after failed previous surgery; five had a tubed buccal mucosal graft as an urethral replacement in the ‘primary’ repair of severe hypospadias. Results There were no complications in 19 patients; two developed fistulae and one a stricture due to graft narrowing. There were no meatal complications. Conclusion Buccal mucosa taken from the inner aspect of the lip is very suitable for reconstructing a failed hypospadias repair, especially when used as an onlay graft.

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Section: Discussionmentioning

confidence: 99%

Buccal mucosal graft for secondary hypospadias repair and urethral replacement

Ahmed

Gough

1997

British Journal of Urology

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“…Although such techniques are still largely employed, in several occasions adverse effects such as fistulas, stenosis, infections, stone formation, graft contracture or diverticula formation may appear. In addition to morbidity at the donor site, there is tissue scarcity when such patients undergo a number of surgical interventions (1,2,(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Integration of collagen matrices into the urethra when implanted as onlay graft

Sayeg¹,

Freitas-Filho²,

Waitzberg

et al. 2013

Int. braz j urol.

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Objective: To assess the integration of decellularized heterologous collagen matrices into the urethra, when implanted with no cells or when seeded with autologous smooth muscle cells. Materials and Methods: Eighteen New Zealand rabbits were randomly assigned to two groups: Group I (n = 9) -animals undergoing urethral segment resection with interposition of a patch of heterologous collagen matrix seeded with autologous smooth muscle cells; Group II (n = 9) -animals undergoing resection of a urethral segment with interposition of a decellularized heterologous collagen matrix patch. Two animals from each group were sacrificed on postoperative days seven, fourteen and twenty-eight; three animals from each group were sacrificed at the end of three postoperative months. At the end of the third month one animal from each group underwent urethroscopy for urethral integrity assessment and one animal from each group had its microcirculation image captured by a SDF device (Side-stream Dark Field -Microscan Analysis Software). One animal from each group in each euthanasia period underwent cystourethrography so as the urethra could be viewed at flow time. The matrices integration was assessed through histological examination using hematoxylin and eosin (H&E), Masson trichrome (MT), Picrosirius red and Von Willebrand staining. In a blind study with two pathologists all the slides were studied. Results: The matrices whether seeded or not with autologous muscle cells were able to restore the architecture of the urethra, but were eliminated from the first week on, before incorporation. Microcirculation of the neourethra, at the end of the third month, showed the same characteristics as a normal urethra in both groups of animals. Conclusion: Natural heterologous matrices implanted in the urethra as onlay graft were not incorporated into its walls but were able to fully restore the cell architecture of the organ, regardless of being seeded or not with autologous muscle cells.

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“…[15][16][17] However, when the local donor tissue is scarce or nonexistent, buccal or bladder mucosal grafts, lyophilized dura mater, saphenous vein, tunica vaginalis, intestinal mucosa, peritoneum, and total or partial skin grafts have been described in clinical and experimental trials. 3,[18][19][20] Of these materials, the buccal mucosa has been widely accepted as the gold standard for the treatment of lesions of the anterior urethra due to its durability and excellent results; however, mucosa graft success rates for repair of pendulous urethra were not so promising. 21,22 An alternative to traditional synthetic materials and tissue grafts currently used is based on the process of spontaneous regeneration of the urethra.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 In an attempt to get better results, numerous procedures have been proposed, including complete surgical excision of the affected urethral segment or partial replacement by autologous materials. [2][3][4] However, even autologous materials may have unsatisfactory results if the conditions of the vascular bed adjacent to the receptor tissue are unfavorable; particularly in multi-operated patients. Furthermore, the use of nongenital tissues for urethroplasty is associated with additional procedures to obtain the graft, prolonging the surgical time, extending the hospital stay, and increasing the morbidity of the procedure.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

Kawano

Fugita

Yamamoto

et al. 2012

Journal of Endourology

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Purpose: Several urethral conditions may require tissue substitution. One collagen-base biomaterial that recently emerged as an option is small intestinal submucosa (SIS). The aim of this study was to compare the results of SIS and buccal mucosa for urethral substitution in rabbits. Materials and Methods: Thirty-six North Folk male rabbits were randomized into three groups. In all animals, a 10 · 5 mm urethral segment was excised, and the urethral defect was repaired using a one-layer SIS patch (group I [GI]); four-layer SIS (group II [GII]); or buccal mucosa (group III [GIII]). Urethrography was performed preoperatively and after 12 weeks. After sacrifice, graft retraction was objectively measured using Scion Image Ò computer analysis and by calculation of ellipse area. The grade of fibrosis, inflammatory reaction, vascular/ epithelial regeneration, and collagen III/I ratio were analyzed by hematoxylin/eosin and Picrosirius red staining. Results: Urethrography confirmed a wide urethral caliber without any signs of strictures after surgery. Urethral fistulae was diagnosed in 8.3% of cases (1 animal each group). Average graft shrinkage was 55.2% in GI; 44.2% in GII; and 57.2% in GIII ( p < 0.05). The intensity of chronic inflammation, fibrosis, epithelium regeneration, and neovascularization was similar in all groups ( p > 0.05). Collagen III/I ratio was higher in GII (GI: 119.6; GII: 257.2 and GIII: 115.0); p < 0.01. Conclusions: The four-layer SIS is more advantageous than the one-layer SIS and buccal mucosa for urethral substitution in rabbits.

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Autologous Buccal Mucosa Graft for Hypospadias Repair: An Initial Report

Cited by 183 publications

References 10 publications

Buccal mucosal graft for secondary hypospadias repair and urethral replacement

Buccal mucosal graft for secondary hypospadias repair and urethral replacement

Integration of collagen matrices into the urethra when implanted as onlay graft

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

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