Departments of Urology and Pathology (SS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Departments of Urology and Pathology (SS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Urol. 2014 Dec;192(6):1725-9. doi: 10.1016/j.juro.2014.06.089. Epub 2014 Jul 3.
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.
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.
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.
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.
移植物植入尿道并暴露于尿液后，颊黏膜移植物的组织病理学变化仍不清楚。我们研究了整合到尿道中的颊黏膜移植物的组织病理学变化。
我们前瞻性评估了 2012 年 11 月至 2013 年 10 月期间因颊黏膜尿道成形术后尿道狭窄而再次接受手术的 22 例患者。所有患者均由同一位外科医生进行重复颊黏膜尿道成形术。术中我们采集了之前植入尿道的整合颊黏膜移植物、健康尿道、对侧内侧颊部新鲜采集的颊黏膜和当前狭窄区域纤维化组织的样本。一位专门的泌尿科病理学家使用苏木精和伊红染色对所有组织样本进行了细致的组织病理学检查。还收集了所有患者的术前临床数据。
从上次到当前颊黏膜尿道成形术的平均间隔时间为 22.2 个月（范围为 4.1 至 76.0）。重复尿道成形术时的平均狭窄长度为 52.7 毫米（范围为 30.0 至 70.0）。所有患者的整合颊黏膜移植物的组织病理学特征均完全保留，由厚的复层非角化鳞状上皮组成，具有棘层。移植物未被尿路上皮部分或全部覆盖。
在人类中，颊黏膜移植物在尿道植入和暴露于尿液后保持其组织病理学特征，并且不会被尿路上皮覆盖。这些发现可能解释了与其他材料相比，颊黏膜移植物在替代尿道成形术结果方面的优越性。
