Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study
The use of buccal mucosa grafts (BMG) for urethral reconstruction has increased in popularity over the last several decades. Our aim was to describe our institutional experience with and outcomes after BMG urethroplasty. We conducted a retrospective cohort study of boys undergoing BMG urethral recon...
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| Veröffentlicht in: | BMC urology 2014-06, Vol.14 (1), p.46-46, Article 46 |
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| creator | Johnson, Emilie K Kozinn, Spencer I Johnson, Kathryn L Kim, Sohee Diamond, David A Retik, Alan B |
| description | The use of buccal mucosa grafts (BMG) for urethral reconstruction has increased in popularity over the last several decades. Our aim was to describe our institutional experience with and outcomes after BMG urethroplasty.
We conducted a retrospective cohort study of boys undergoing BMG urethral reconstruction. Preoperative and perioperative characteristics and postoperative outcomes were evaluated.
Twenty-nine patients (median age 8.2 years) underwent BMG urethroplasty from 1995-2012. Of the 10 patients undergoing 1-stage repairs, 6 had tubularized grafts, the last of which was performed in 2000 due to an unacceptably high revision rate (100%). A 2-stage approach was elected for 19 patients (median follow-up 21.3 months). Complications including stricture, fistula, or chordee were seen in 60% of patients completing both stages and 32% required ≥1 revision. However, 71% of 2-stage patients were free of significant problems at last follow-up.
We found BMG to be a reasonable option for use in complex pediatric urethral reconstruction. Tubularized grafts had poor results, and we no longer use them. We favor a 2-stage approach for all patients except those with "simple" non-hypospadiac strictures. Although revision procedures were not uncommon, the majority of patients were ultimately free of long-term problems. |
| doi_str_mv | 10.1186/1471-2490-14-46 |
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We conducted a retrospective cohort study of boys undergoing BMG urethral reconstruction. Preoperative and perioperative characteristics and postoperative outcomes were evaluated.
Twenty-nine patients (median age 8.2 years) underwent BMG urethroplasty from 1995-2012. Of the 10 patients undergoing 1-stage repairs, 6 had tubularized grafts, the last of which was performed in 2000 due to an unacceptably high revision rate (100%). A 2-stage approach was elected for 19 patients (median follow-up 21.3 months). Complications including stricture, fistula, or chordee were seen in 60% of patients completing both stages and 32% required ≥1 revision. However, 71% of 2-stage patients were free of significant problems at last follow-up.
We found BMG to be a reasonable option for use in complex pediatric urethral reconstruction. Tubularized grafts had poor results, and we no longer use them. We favor a 2-stage approach for all patients except those with "simple" non-hypospadiac strictures. Although revision procedures were not uncommon, the majority of patients were ultimately free of long-term problems.</description><identifier>ISSN: 1471-2490</identifier><identifier>EISSN: 1471-2490</identifier><identifier>DOI: 10.1186/1471-2490-14-46</identifier><identifier>PMID: 24902693</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adolescent ; Child ; Cohort Studies ; Female ; Humans ; Male ; Mouth Mucosa - transplantation ; Reconstructive Surgical Procedures - methods ; Retrospective Studies ; Treatment Outcome ; Urethra - surgery ; Urethral Stricture - diagnosis ; Urethral Stricture - surgery ; Urologic Surgical Procedures - methods ; Urology</subject><ispartof>BMC urology, 2014-06, Vol.14 (1), p.46-46, Article 46</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Johnson et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Copyright © 2014 Johnson et al.; licensee BioMed Central Ltd. 2014 Johnson et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-760c8803285e4e9e173494ebcd868f399aab313e89e4a5be249f0a2142ef6f0b3</citedby><cites>FETCH-LOGICAL-c521t-760c8803285e4e9e173494ebcd868f399aab313e89e4a5be249f0a2142ef6f0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066324/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066324/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24902693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnson, Emilie K</creatorcontrib><creatorcontrib>Kozinn, Spencer I</creatorcontrib><creatorcontrib>Johnson, Kathryn L</creatorcontrib><creatorcontrib>Kim, Sohee</creatorcontrib><creatorcontrib>Diamond, David A</creatorcontrib><creatorcontrib>Retik, Alan B</creatorcontrib><title>Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study</title><title>BMC urology</title><addtitle>BMC Urol</addtitle><description>The use of buccal mucosa grafts (BMG) for urethral reconstruction has increased in popularity over the last several decades. Our aim was to describe our institutional experience with and outcomes after BMG urethroplasty.
We conducted a retrospective cohort study of boys undergoing BMG urethral reconstruction. Preoperative and perioperative characteristics and postoperative outcomes were evaluated.
Twenty-nine patients (median age 8.2 years) underwent BMG urethroplasty from 1995-2012. Of the 10 patients undergoing 1-stage repairs, 6 had tubularized grafts, the last of which was performed in 2000 due to an unacceptably high revision rate (100%). A 2-stage approach was elected for 19 patients (median follow-up 21.3 months). Complications including stricture, fistula, or chordee were seen in 60% of patients completing both stages and 32% required ≥1 revision. However, 71% of 2-stage patients were free of significant problems at last follow-up.
We found BMG to be a reasonable option for use in complex pediatric urethral reconstruction. Tubularized grafts had poor results, and we no longer use them. We favor a 2-stage approach for all patients except those with "simple" non-hypospadiac strictures. Although revision procedures were not uncommon, the majority of patients were ultimately free of long-term problems.</description><subject>Adolescent</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mouth Mucosa - transplantation</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Urethra - surgery</subject><subject>Urethral Stricture - diagnosis</subject><subject>Urethral Stricture - surgery</subject><subject>Urologic Surgical Procedures - methods</subject><subject>Urology</subject><issn>1471-2490</issn><issn>1471-2490</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkstrHSEUh6U0NI923V0RuulmEh0dx-miEEKbBgLZJGtxnOO9hhm99RHIf1-nSS9JKS6Uc77z87wQ-kjJKaVSnFHe06blA2kob7h4g472lrcv3ofoOKV7QmgvO_EOHa62VgzsCOm7BDhYPBZj9IyXYkLSeBO1zQnbEHGJkLexuiKY4FOOxWQXPHYem62bpwj-K9bVm2NIO6jOB8AmbEPMOOUyPb5HB1bPCT483yfo7sf324ufzfXN5dXF-XVjupbmphfESElYKzvgMADtGR84jGaSQlo2DFqPjDKQA3DdjVBLsES3lLdghSUjO0HfnnR3ZVxgMuBzTVvtolt0fFRBO_Xa491WbcKD4kQI1vIq8OVZIIZfBVJWi0sG5ll7CCUp2nFCWzr0rKKf_0HvQ4m-llcpNnSC0Zr_ntroGZTzNtR_zSqqzislZMu4qNTpf6h6JlhcbTlYV-2vAs6eAkzteIpg9zVSotatUOvc1Trj-lJ_Ij69bM2e_7sG7DfYwbIF</recordid><startdate>20140605</startdate><enddate>20140605</enddate><creator>Johnson, Emilie K</creator><creator>Kozinn, Spencer I</creator><creator>Johnson, Kathryn L</creator><creator>Kim, Sohee</creator><creator>Diamond, David A</creator><creator>Retik, Alan B</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140605</creationdate><title>Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study</title><author>Johnson, Emilie K ; Kozinn, Spencer I ; Johnson, Kathryn L ; Kim, Sohee ; Diamond, David A ; Retik, Alan B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-760c8803285e4e9e173494ebcd868f399aab313e89e4a5be249f0a2142ef6f0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mouth Mucosa - transplantation</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Urethra - surgery</topic><topic>Urethral Stricture - diagnosis</topic><topic>Urethral Stricture - surgery</topic><topic>Urologic Surgical Procedures - methods</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnson, Emilie K</creatorcontrib><creatorcontrib>Kozinn, Spencer I</creatorcontrib><creatorcontrib>Johnson, Kathryn L</creatorcontrib><creatorcontrib>Kim, Sohee</creatorcontrib><creatorcontrib>Diamond, David A</creatorcontrib><creatorcontrib>Retik, Alan B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnson, Emilie K</au><au>Kozinn, Spencer I</au><au>Johnson, Kathryn L</au><au>Kim, Sohee</au><au>Diamond, David A</au><au>Retik, Alan B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study</atitle><jtitle>BMC urology</jtitle><addtitle>BMC Urol</addtitle><date>2014-06-05</date><risdate>2014</risdate><volume>14</volume><issue>1</issue><spage>46</spage><epage>46</epage><pages>46-46</pages><artnum>46</artnum><issn>1471-2490</issn><eissn>1471-2490</eissn><abstract>The use of buccal mucosa grafts (BMG) for urethral reconstruction has increased in popularity over the last several decades. Our aim was to describe our institutional experience with and outcomes after BMG urethroplasty.
We conducted a retrospective cohort study of boys undergoing BMG urethral reconstruction. Preoperative and perioperative characteristics and postoperative outcomes were evaluated.
Twenty-nine patients (median age 8.2 years) underwent BMG urethroplasty from 1995-2012. Of the 10 patients undergoing 1-stage repairs, 6 had tubularized grafts, the last of which was performed in 2000 due to an unacceptably high revision rate (100%). A 2-stage approach was elected for 19 patients (median follow-up 21.3 months). Complications including stricture, fistula, or chordee were seen in 60% of patients completing both stages and 32% required ≥1 revision. However, 71% of 2-stage patients were free of significant problems at last follow-up.
We found BMG to be a reasonable option for use in complex pediatric urethral reconstruction. Tubularized grafts had poor results, and we no longer use them. We favor a 2-stage approach for all patients except those with "simple" non-hypospadiac strictures. Although revision procedures were not uncommon, the majority of patients were ultimately free of long-term problems.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24902693</pmid><doi>10.1186/1471-2490-14-46</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Child Cohort Studies Female Humans Male Mouth Mucosa - transplantation Reconstructive Surgical Procedures - methods Retrospective Studies Treatment Outcome Urethra - surgery Urethral Stricture - diagnosis Urethral Stricture - surgery Urologic Surgical Procedures - methods Urology |
| title | Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study |
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