Comparison study on donor site complications between buccal and lingual oral mucosal grafts harvesting for urethroplasty / 中华泌尿外科杂志

ABSTRACT

Objective To compare donor site complications of buccal or lingual mucosa grafts harvesting for substitution urethroplasty.Methods From June 2014 to December 2016,a total of 50 patients who were diagnosed anterior urethral strictures or hypospadias underwent buccal or lingual mucosa grafts urethroplasty.The mean age of the patients was 43.6 years (range 32-56 years).25 patients used buccal mucosa grafts (BMG group) for urethroplasty with the median age of 43.1 years (range 32-54 years);the other 25 patients received lingual mucosa grafts (LMG group) for urethroplasty,aged 44.2 years (range 35-56 years).Patients were evaluated for postoperative oral pain morbidity using the visual analogue pain scale (0-10) as well as an questionnaire for difficulty with eating,speech impairment,dysgeusia,tightness of the mouth.The evaluations were carried out at 3 days,2 weeks and 3 months postoperatively.Results In BMG group,the length and width of the graft was (5.24 ± 0.89) cm and (1.48 ± 0.50) cm;the graft length was (5.68 ± 0.90) cm and the width was (1.56 ± 0.51) cm in LMG group.There was no difference between the two groups.The mean followup time was (7.8 ± 1.2) months (6-12 months).The median visual analogue pain scale scores of the BMG group 3 days,2 weeks after surgery was 5.84 ±0.85,3.04 ±0.45,and the LMG group 7.20 ±0.57,4.16 ±0.62,respectively,with no statistical difference between two groups.The incidence of events with LMG group versus the BMG group were as followsdifficulty with eating (64％ vs.24％,P =0.004),speech impairment (92％ vs.56％,P=0.004) and dysgeusia (48％ vs.16％,P =0.015)at day 3.The difficulty of eating,speech impairment and dysgeusia of BMG group were lower than that of the LMG group(16％ vs.32％,P =0.031;8％ vs.40％,P =0.008;12％ vs.40％,P =0.024) two weeks after the surgery,whereas the incidence of tightness of the mouth was higher in BMG group(36％ vs.12％,P =0.04).After 3 months,36％ and 32％ of patients treated with buccal and lingual mucosa grafts urethroplasty still reported sensitivity perioral numbness(P ＞ 0.05).Conclusions Oral mucosa grafts are good for substitution urethroplasty,but also with some donor site complications.The early postoperative complications are more common in lingual mucosa graft donor site.Buccal mucosa may be used as the preferred graft for urethroplasty.Lingual mucosal graft may be considered in cases of unavailable buccal mucosa graft or the length of the graft not enough and combined graft treatment.