Singh Kirti, Gaur Abhay Singh, Mandal Swarnendu, Tarigopula Vivek, Das Manoj Kumar, Tripathy Sambit, Sabique C, Barik Kalandi, Nayak Prasant
Urology Department, AIIMS Bhubaneswar, Sijua, Patrapada, Bhubaneswar, Odisha, 751019, India.
Department of Urology, AIIMS Bhatinda, Bhatinda, Punjab, India.
Int Urol Nephrol. 2025 Apr 29. doi: 10.1007/s11255-025-04526-x.
To conduct a comparative analysis of autologous adult live cultured buccal epithelial cells (AALBEC) and minced buccal mucosal graft endourethral urethroplasty (MBGEU) in treatment of bulbar urethral stricture disease (USD) by evaluating and comparing their efficacy, safety, and patient outcomes.
This study was conducted in a tertiary-care center and included 90 males with primary, < 4 cm bulbar USD. In AALBEC arm (30 patients), AALBEC was implanted after DVIU. While in the MBGEU arm (60 patients), a 1 × 1 cm buccal mucosal graft was harvested, minced, centrifuged, and suspended in fibrin glue, and after DVIU, the suspension was instilled via a 5-Fr ureteric catheter over the urethrotomy site. The primary objective was to compare success rates. The secondary objectives were to compare changes in the American Urological Association (AUA) symptom score, peak flow rate (Qmax), and post-void residue (PVRU) post-operatively and also to look for any adverse events related to surgery.
The success rate of AALBEC was 73.33% and of MBGEU was 90% at 6 months (p 0.041). The stricture recurred in eight and six patients, respectively. Although both groups showed a significant increase in Qmax compared to preoperative values, MBGEU group demonstrated significantly greater improvement in Qmax at 3 months (p 0.002) and 6 months (p < 0.0001) compared to the AALBEC group. No significant donor site morbidity was seen. In AALBEC group, two patients had sepsis in postoperative period.
The medium-term success of MBGEU is encouraging over AALBEC. However, a longer follow-up and further studies with a larger sample size are required.
通过评估和比较自体成年活培养颊黏膜上皮细胞（AALBEC）和颊黏膜碎块移植尿道内尿道成形术（MBGEU）治疗球部尿道狭窄疾病（USD）的疗效、安全性和患者预后，进行对比分析。
本研究在一家三级医疗中心开展，纳入90例患有原发性、球部尿道狭窄长度<4 cm的男性患者。在AALBEC组（30例患者）中，在经尿道内切开术后植入AALBEC。而在MBGEU组（60例患者）中，取1×1 cm的颊黏膜移植物，切碎、离心，悬浮于纤维蛋白胶中，经尿道内切开术后，通过5F输尿管导管将悬浮液滴注在尿道切开部位。主要目的是比较成功率。次要目的是比较术后美国泌尿外科学会（AUA）症状评分、最大尿流率（Qmax）和残余尿量（PVRU）的变化，并寻找与手术相关的任何不良事件。
6个月时，AALBEC的成功率为73.33%，MBGEU的成功率为90%（p = 0.041）。分别有8例和6例患者出现狭窄复发。尽管两组的Qmax均较术前值显著增加，但与AALBEC组相比，MBGEU组在3个月（p = 0.002）和6个月（p < 0.0001）时Qmax的改善更为显著。未观察到明显的供区并发症。在AALBEC组，2例患者术后发生败血症。
MBGEU的中期成功率优于AALBEC，令人鼓舞。然而，需要更长时间的随访和更大样本量的进一步研究。
