Limits...
The long-term results of lingual mucosal grafts for repairing long anterior urethral strictures.

Abdelhameed H, Elgamal S, Farha MA, El-Abd A, Tawfik A, Soliman M - Arab J Urol (2015)

Bottom Line: The mean (range) follow-up was 66 (60-72) months.There were no fistulae or clinically perceptible graft sacculations, and no long-term donor-site complications.This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.

View Article: PubMed Central - PubMed

Affiliation: Fayoum Faculty of Medicine, Fayoum, Egypt.

ABSTRACT

Objective: To evaluate the long-term results of repairing long anterior urethral strictures with lingual mucosa onlay grafts.

Patients and methods: This study included 23 patients (mean age 36.3 years, range 21-62) who had a lingual mucosa onlay graft for managing a long anterior urethral stricture, and who were followed up for ⩾5 years. The mean length of the stricture was 4.6 cm. The International Prostate Symptom Score and uroflowmetry values were obtained before surgery, and at 3, 6 and 12 months afterwards, and annually thereafter. A retrograde urethrogram with a voiding cysto-urethrogram was taken before surgery, at catheter removal, after 3 and 6 months, and selectively thereafter.

Results: The mean (range) follow-up was 66 (60-72) months. The cause of the stricture was trauma in nine patients, instrumentation in seven, idiopathic in four, urethritis in two and previous hypospadias repair in one. The surgery was successful in 20 of the 23 patients (87%), and a recurrent stricture developed in the remaining three. There were no fistulae or clinically perceptible graft sacculations, and no long-term donor-site complications.

Conclusions: With a long-term follow-up, our series confirms the durability of lingual mucosal onlay grafts for treating long anterior urethral strictures. This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.

No MeSH data available.


Related in: MedlinePlus

De-fatting of the LMG.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4561919&req=5

f0015: De-fatting of the LMG.

Mentions: A mouth opener was used and the tongue was pulled outside the mouth with a Babcock clamp, exposing the tongue’s ventrolateral surface. The site of the graft was from ventral to lateral mucosa of the tongue. Initially the graft was marked with a surgical pen, with care to avoid injury to the opening of the submandibular duct (Wharton duct) at the base of the tongue on the side of the frenum linguae. We infiltrated the graft site with normal saline and 0.01% adrenaline. We incised the graft edges with a scalpel and a full-thickness mucosal graft was harvested using scissors (Fig. 1). The graft bed was carefully examined for bleeding and closed using polyglactin 3–0 running sutures (Fig. 2). The graft was de-fatted to remove all submucosal tissues (Fig. 3). When needed, the graft was harvested bilaterally.


The long-term results of lingual mucosal grafts for repairing long anterior urethral strictures.

Abdelhameed H, Elgamal S, Farha MA, El-Abd A, Tawfik A, Soliman M - Arab J Urol (2015)

De-fatting of the LMG.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561919&req=5

f0015: De-fatting of the LMG.
Mentions: A mouth opener was used and the tongue was pulled outside the mouth with a Babcock clamp, exposing the tongue’s ventrolateral surface. The site of the graft was from ventral to lateral mucosa of the tongue. Initially the graft was marked with a surgical pen, with care to avoid injury to the opening of the submandibular duct (Wharton duct) at the base of the tongue on the side of the frenum linguae. We infiltrated the graft site with normal saline and 0.01% adrenaline. We incised the graft edges with a scalpel and a full-thickness mucosal graft was harvested using scissors (Fig. 1). The graft bed was carefully examined for bleeding and closed using polyglactin 3–0 running sutures (Fig. 2). The graft was de-fatted to remove all submucosal tissues (Fig. 3). When needed, the graft was harvested bilaterally.

Bottom Line: The mean (range) follow-up was 66 (60-72) months.There were no fistulae or clinically perceptible graft sacculations, and no long-term donor-site complications.This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.

View Article: PubMed Central - PubMed

Affiliation: Fayoum Faculty of Medicine, Fayoum, Egypt.

ABSTRACT

Objective: To evaluate the long-term results of repairing long anterior urethral strictures with lingual mucosa onlay grafts.

Patients and methods: This study included 23 patients (mean age 36.3 years, range 21-62) who had a lingual mucosa onlay graft for managing a long anterior urethral stricture, and who were followed up for ⩾5 years. The mean length of the stricture was 4.6 cm. The International Prostate Symptom Score and uroflowmetry values were obtained before surgery, and at 3, 6 and 12 months afterwards, and annually thereafter. A retrograde urethrogram with a voiding cysto-urethrogram was taken before surgery, at catheter removal, after 3 and 6 months, and selectively thereafter.

Results: The mean (range) follow-up was 66 (60-72) months. The cause of the stricture was trauma in nine patients, instrumentation in seven, idiopathic in four, urethritis in two and previous hypospadias repair in one. The surgery was successful in 20 of the 23 patients (87%), and a recurrent stricture developed in the remaining three. There were no fistulae or clinically perceptible graft sacculations, and no long-term donor-site complications.

Conclusions: With a long-term follow-up, our series confirms the durability of lingual mucosal onlay grafts for treating long anterior urethral strictures. This procedure results in a long-term high success rate with few of the complications that occur primarily during the first year.

No MeSH data available.


Related in: MedlinePlus