Nafie Ahmed Moustafa, Nafie Mahmoud Moustafa, Aosmali Ahmed, Soliman Basma Mohamed
Department of Urology, Frimley Park Hospital, Frimley, Surrey GU16 7UJ, England.
Department of General Surgery, King's College Hospital, London SE5 9RS, England.
Bladder (San Franc). 2025 May 5;12(2):e21200043. doi: 10.14440/bladder.2024.0063. eCollection 2025.
Urethral stricture is characterized by long-term scarring and narrowing of the urethral canal caused by acute trauma, inflammation, or medical procedures, such as urethral instrumentation or surgery. Despite the widespread use of both buccal and lingual mucosal grafts (LMG) in urethroplasty, few prospective studies have directly compared their surgical outcomes and donor site morbidity. This study aims to fill that gap.
This study compares the use of buccal and LMG in managing anterior urethral stricture with surgical outcomes and donor site morbidity evaluations.
This case-control comparative study was conducted at Ain Shams University Hospital. Patients who attended the urology outpatient clinic, presenting with lower urinary tract symptoms secondary to stricture anterior urethra and underwent surgical management by urethroplasty with a dorsal onlay technique, were selected as cases.
No statistically significant differences were observed between the studied groups regarding age, smoking status, comorbidities, related urinary conditions, or the presence of a urinary catheter. In addition, the groups had no significant differences concerning stricture characteristics, graft details, or operation specifics. Similarly, general and urethral outcomes showed no statistically significant variation between the groups. Problems with drinking, soft food consumption, solid food consumption, dysgeusia, and speaking were significantly less frequent in the buccal mucosal graft (BMG) group than in the LMG group. In contrast, oral tightness was significantly more frequent in the BMG group than in the LMG group.
The study concluded that buccal and LMG effectively repair anterior urethral stricture, showing similar success rates. However, LMG patients experience earlier oral complications, while BMG patients face more long-term oral tightness, making graft choice dependent on patient-specific tolerances.
尿道狭窄的特征是由急性创伤、炎症或医疗操作（如尿道器械检查或手术）导致尿道长期瘢痕形成和管腔狭窄。尽管颊黏膜和舌黏膜移植物（LMG）在尿道成形术中广泛应用，但很少有前瞻性研究直接比较它们的手术效果和供区并发症。本研究旨在填补这一空白。
本研究比较颊黏膜和LMG在治疗前尿道狭窄方面的应用，并评估手术效果和供区并发症。
本病例对照比较研究在艾因夏姆斯大学医院进行。选择因前尿道狭窄继发下尿路症状并在泌尿外科门诊就诊、接受背侧镶嵌技术尿道成形术手术治疗的患者作为病例。
在研究组之间，年龄、吸烟状况、合并症、相关泌尿系统疾病或留置导尿管情况方面未观察到统计学显著差异。此外，两组在狭窄特征、移植物细节或手术具体情况方面也无显著差异。同样，两组的总体和尿道相关结果在统计学上也无显著差异。颊黏膜移植物（BMG）组在饮水、食用软食、食用固体食物、味觉障碍和说话方面的问题比LMG组明显更少。相比之下，BMG组口腔紧绷感明显比LMG组更频繁。
该研究得出结论，颊黏膜和LMG均能有效修复前尿道狭窄，成功率相似。然而，LMG患者出现口腔并发症较早，而BMG患者面临更长期的口腔紧绷感，移植物的选择取决于患者的具体耐受性。
