Buccal Mucosa Graft for Ureteral Stricture Substitution: Initial Experience

An Alternative Technique for Treating Complex Ureteral Strictures and Defects using A Peritoneal Graft

“…Further more, if the stricture involves the middle ureter, the risk of ischemic necrosis, due to the reduced vascular supply of this segment, can be high even for shorter lesions and an end to end anastomosis is not recommended even if feasible, As alternative to these complex procedures, based on the evidence that atonic ureters affected by schistosomiasis can drain well by gravity and on the success of buccal mucosal graft in the repair of complicated hypospadias, Naude and other Authors [13][14][15] have reported the successfull use of buccal mucosal patch graft for the reconstruction of a variety of ureteric lesions without major complications. [16][17][18] Animal experiments have showed, that a free peritoneal graft, used as bladder substitute, works like a multipotent matrix for urethelialization of the reconstructed area, supporting the migration of the smooth muscle cells from the edges of the defects in a centripetal direction [19][20][21].…”

Oral Mucosa Graft

“…Naude (1999) treated 4 patients with long segment ureteral loss using oral mucosa grafts applied as a patch wrapped with omentum. However, Badawy and co-workers(2010) reported a series of five patients who presented with extensive ureteral strictures who had oral mucosa grafts laid and fixed to the ureteral adventitia and tubularized over a double -J stent (Badawy et al, 2010). Although there is paucity of this application of oral mucosa grafts in the literature at the present, increasing use of this will increase.…”

Urothelial-based reconstructive surgery for upper- and mid-ureteral defects: Long-term results

“…The optional surgical reconstructive approaches for those cases include the use of bowel interposition, buccal graft, autotransplantation, urothelial-based ureteral reconstruction, and rarely, nephrectomy, the latter of which is the only definitive solution. [3][4][5][6] Urothelial-based ureteral reconstruction of the mid-and upper-ureter has several advantages, including avoidance of bowel surgery (i.e., ileal ureter) or vascular surgery (i.e., autotransplantation) and the ability to preserve renal function. On the other hand, it is a complicated procedure and the functional long-term data on large cohorts are limited.…”