Simonato Alchiede, Gregori Andrea, Lissiani Andrea, Galli Stefano, Ottaviani Francesco, Rossi Roberta, Zappone Anna, Carmignani Giorgio
Department of Urology Luciano Giuliani, University of Genoa, Genoa, Milan, Italy.
J Urol. 2006 Feb;175(2):589-92. doi: 10.1016/S0022-5347(05)00166-7.
Urethroplasty with a buccal mucosal graft provides excellent clinical results but it may also cause oral complications in some cases. The mucosa covering the lateral and under surface of the tongue is identical in structure with that lining the rest of the oral cavity. We evaluated LMGs for urethroplasty.
From January 2001 to September 2004, 8 men 34 to 65 years old (mean age 46.1) with urethral strictures 1.5 to 4.5 cm long were selected for 1-stage dorsal onlay urethroplasty. The site of the harvest graft was the lateral mucosal lining of the tongue. Postoperatively all patients were followed with urethrography, uroflowmetry, cystourethrography and flexible urethroscopy after 3 and 12 months. Successful reconstruction criteria were peak flow rate greater than 15 ml per second and no need for postoperative urethral dilation.
Median followup was 18 months (mean 22.1, range 3 to 47). Seven cases were successful. One patient had a partial urethral stricture. In successful cases cystourethrography revealed no significant graft contractures or sacculations and at flexible urethroscopy LMG was almost indistinguishable from native urethra. There were no pain, esthetic or functional complications at the donor site.
Harvesting the LMG is feasible and easy to perform. Compared with the buccal mucosal graft the LMG seems to be associated with less postoperative pain and a minor risk of donor site complications. These preliminary functional and esthetic data are satisfactory.
采用颊黏膜移植进行尿道成形术可取得优异的临床效果，但在某些情况下也可能导致口腔并发症。覆盖舌侧面和下面的黏膜在结构上与口腔其余部位的内衬黏膜相同。我们评估了舌侧黏膜移植用于尿道成形术的效果。
从2001年1月至2004年9月，选择8例年龄在34至65岁（平均年龄46.1岁）、尿道狭窄长度为1.5至4.5厘米的男性患者，进行一期背侧覆盖式尿道成形术。移植取材部位为舌的侧黏膜。术后所有患者在3个月和12个月时接受尿道造影、尿流率测定、膀胱尿道造影和软性尿道镜检查。成功重建的标准为峰值尿流率大于每秒15毫升且术后无需尿道扩张。
中位随访时间为18个月（平均22.1个月，范围3至47个月）。7例成功。1例患者出现部分尿道狭窄。在成功的病例中，膀胱尿道造影显示无明显的移植片挛缩或囊状扩张，软性尿道镜检查显示舌侧黏膜移植与天然尿道几乎无差异。供体部位无疼痛、美观或功能方面的并发症。
获取舌侧黏膜移植是可行且易于操作的。与颊黏膜移植相比，舌侧黏膜移植似乎术后疼痛较轻且供体部位并发症风险较小。这些初步的功能和美观数据令人满意。
