What Is the Best Way to Prepare A Buccal Mucosa Graft for Urethroplasty? A Histology-Based Preliminary Report.
Cavalcanti AG1, Restrepo CF1, Simões M2, Costa WS2, Sampaio FJB2, de Souza DB2.
Author information
1
Department of General and Specialized Surgery, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
2
Urogenital Research Unit, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Abstract
PURPOSE:
To evaluate the histological characteristics of buccal mucosa samples prepared using different dissection techniques.

METHODS:
The buccal mucosae harvested from 9 men submitted to a substitution urethroplasty were used in this study. Biopsy specimens of buccal mucosae were grouped according to the macroscopic appearance after dissection: Group 1 – yellowish appearance (minimal dissection), Group 2 – whitish appearance (more aggressive dissection), and Group 3 – translucent appearance (ultra-aggressive dissection). The biopsy specimens were evaluated using histomorphometric techniques. The thicknesses of the graft, epithelium, and sub-epithelial connective tissue were compared.

RESULTS:
The samples from Group 3 and Groups 2 and 3 presented lower total and lower sub-epithelial connective tissue thickness, respectively, when compared with Group 1. The epithelial thickness was not affected by the dissection method. Muscular and adipose tissues were present in 77 and 55% of samples from Group 1, respectively, whereas these were observed in 44 and 22% of samples from Group 2 respectively. The muscular tissue was observed in 11% of the cases, and the adipose tissue was not observed in samples prepared with ultra-aggressive dissection.

CONCLUSION:
We conclude that an intermediate graft dissection (whitish appearance, as performed in Group 2) presents the best balance between subepithelial connective tissue preservation and adipose and muscle tissue removal.

© 2018 S. Karger AG, Basel.

KEYWORDS:
Buccal mucosa; Graft; Urethra; Urethroplatsy

PMID: 29649831 DOI: 10.1159/000488805