Literature DB >> 15247736

The morbidity of buccal mucosal graft harvest for urethroplasty and the effect of nonclosure of the graft harvest site on postoperative pain.

D N Wood1, S E Allen, D E Andrich, T J Greenwell, A R Mundy.   

Abstract

PURPOSE: We assess the medium and long-term morbidity of buccal mucosal graft (BMG) harvest for urethroplasty, and evaluate the effect of nonclosure of the graft harvest site on postoperative pain.
MATERIALS AND METHODS: A questionnaire was mailed to 110 men who underwent BMG urethroplasty between January 1, 1997 and August 31, 2002. Demographic data and side effects of BMG harvest, including oral pain, sensation and intake, were assessed postoperatively. A prospective study was then performed to compare 20 unselected men whose BMG donor site was closed with a group of 20 men in whom it was left open using a 5-point analog pain score that was completed twice daily for the first 5 postoperative days.
RESULTS: A total of 49 men with a median age of 49 years (range 23 to 73) returned questionnaires relating to 57 BMG harvests. Of the graft harvests 47 (83%) were associated with postoperative pain, which was worse than expected in 24 (51%). Of the 57 patients 51 (90%) resumed oral liquid intake within 24 hours and 44 (77%) resumed normal diet within 1 week. Postoperative side effects included perioral numbness in 39 (68%) patients with 15 (26%) having residual numbness after 6 months, initial difficulty with mouth opening in 38 (67%) with 5 (9%) having persistent problems, changes in salivation in 6 (11%) and mucous retention cyst that required excision in 1 (2%). The men in the prospective donor site study had a median age of 51 years (range 24 to 70). Mean pain score for patients with donor site closure was 3.68 and was significantly higher than that for patients without donor site closure (2.26, p < 0.01).
CONCLUSIONS: Buccal mucosal graft harvest is not a pain-free procedure. Closure of the harvest donor site appears to worsen this pain and it may be best to leave harvest sites open. The main long-term complications are perioral numbness, persistent difficulty with mouth opening and change in salivary function.

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Year:  2004        PMID: 15247736     DOI: 10.1097/01.ju.0000132846.01144.9f

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  37 in total

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2.  [Urethral reconstruction using buccal mucosa transplants].

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3.  [Management and prevention of complications in open urethral surgery. End-to-end anastomosis and buccal mucosa urethroplasty].

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Authors:  Andrew Wang; Michael Chua; Vishal Talla; Nicolas Fernandez; Jessica Ming; Esther May Sarino; Jessica DeLong; Ramón Virasoro; Jeremy Tonkin; Kurt McCammon
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5.  Anterior urethral reconstruction using the circular fasciocutaneous flap technique: long-term follow-up.

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Journal:  World J Urol       Date:  2010-04-09       Impact factor: 4.226

6.  Donor site morbidity in oral mucosa graft urethroplasty: implications of tobacco consumption.

Authors:  Rahul Janak Sinha; Vishwajeet Singh; S N Sankhwar; Divakar Dalela
Journal:  BMC Urol       Date:  2009-09-21       Impact factor: 2.264

7.  Healing of Donor-site Buccal Mucosa Urethroplasty.

Authors:  Amjad Alwaal; Catherine R Harris; Anthony Enriquez; Jack W McAninch; Benjamin N Breyer
Journal:  Urology       Date:  2015-07-04       Impact factor: 2.649

8.  Buccal mucosa urethroplasty: a 10-year retrospective review of maxillofacial and urological outcomes.

Authors:  J E O'Connell; I M Cullen; C Murphy; H Flood; G J Kearns
Journal:  Ir J Med Sci       Date:  2014-07-04       Impact factor: 1.568

9.  Evaluation of intraoral complications of buccal mucosa graft in augmentation urethroplasty.

Authors:  Mehmet Akyüz; Mustafa Güneş; Orhan Koca; Zülfü Sertkaya; Hüseyin Kanberoğlu; Muhammet İhsan Karaman
Journal:  Turk J Urol       Date:  2014-09

10.  Lingual mucosal graft substitution urethroplasty for anterior urethral strictures: our technique of graft harvesting.

Authors:  Abhay Kumar; Suren K Das; Girish K Sharma; Ashwani K Pandey; Sameer Trivedi; Udai S Dwivedi; Pratap B Singh
Journal:  World J Urol       Date:  2008-04-19       Impact factor: 4.226

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