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New tissue-engineered oral mucosa graft using standard techniques for anterior urethroplasty

07 Aug 2018

Standard techniques for anterior urethroplasty and native oral mucosa can be used to implant a tissue-engineered oral mucosa graft with a similar success rate, a recent study has shown.

In the patient cohort (n=38; median age 57 years), strictures were penile in three (7.9 percent), bulbar in 29 (76.3 percent) and penobulbar in six (15.8 percent). Median stricture length was 5 cm, and median follow-up was 55 months.

Thirty-two (84.2 percent) patients had a successful treatment, while six (15.8 percent) failed. Success was achieved in 85.7 percent of ventral onlay, 83.3 percent of dorsal onlay, 80 percent of dorsal inlay and 100 percent of combined technique cases.

There were no local or systemic adverse reactions due to the engineered material.

In this retrospective multicentre study, the authors recruited patients with recurrent strictures, except those with failed hypospadias, lichen sclerosus, traumatic and posterior strictures. A 0.5-cm2 oral mucosa biopsy was taken from the patient cheek and sent to the laboratory to manufacture the graft.

After 3 weeks, the tissue-engineered oral mucosal MukoCell graft was sent to the hospital for urethroplasty. The following techniques were used: ventral onlay, doral onlay, dorsal inlay and a combined technique.

A month after operation, cystourethrography was performed. Patients underwent clinical evaluation, uroflowmetry and postvoid residual urine measurement every 6 months. Urethrography was repeated in patients showing obstructive symptoms, defined as maximum urine flow <12 ml per second. Those who underwent further treatment for recurrent stricture were classified as having treatment failure.

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