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Harnröhrenrekonstruktion unter Verwendung von Mundschleimhauttransplantaten

Urethral reconstruction using buccal mucosa transplants

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Zusammenfassung

Mundschleimhaut ist ein ideales Material, um Urothel der Harnröhre zu ersetzen. Ihre Verwendung bietet sich v. a. dadurch an, dass sie einfach zu gewinnen ist, an ständigen Kontakt mit Feuchtigkeit gewöhnt ist und in jeder Lokalisation der Harnröhre einsetzbar ist. Die Strikturlänge, die Lokalisation und der Zustand des betroffenen Harnröhrenabschnitts entscheiden über die Operationstechnik, in der die Mundschleimhaut Verwendung findet. Offene Harnröhrenplastiken mit Mundschleimhaut haben eine Erfolgsrate von > 85 % und sollten nach erfolgloser Urethrotomie sowie längerstreckigen Strikturen eingesetzt werden.

Abstract

Buccal mucosa is the ideal material for urethral reconstruction because it is easy to harvest, is accustomed to permanent moisture and can be used at any location in the urethra. Stricture length and local conditions of the urethra have to be considered to decide which technique is required to reconstruct the urethra. Open urethroplasty with buccal mucosa has a success rate over 85 % and should be used after unsuccessful internal urethrotomy and primarily in longer strictures.

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Literatur

  1. el-Kasaby AW, Fath-Alla M, Noweir AM et al (1993) The use of buccal mucosa patch graft in the management of anterior urethral strictures. J Urol 149:276–278

    PubMed  CAS  Google Scholar 

  2. Fichtner J, Fisch M, Filipas D et al (1998) Refinements in buccal mucosal grafts urethroplasty for hypospadias repair. World J Urol 16:192

    Article  PubMed  CAS  Google Scholar 

  3. Presman D, Greenfield DL (1953) Reconstruction of the perineal urethra with a free full-thickness skin graft from the prepuce. J Urol 69:677–680

    PubMed  CAS  Google Scholar 

  4. Devine PC, Horton CE, Devine CJ Sr et al (1963) Use of full thickness skin grafts in repair of urethral strictures. J Urol 90:67–71

    PubMed  CAS  Google Scholar 

  5. Huybers TJ, Stoelinga PJ, De Koomen HA, Tideman H (1985) Mandibular vestibuloplasty using a free mucosal graft: a 2–7 year evaluation. Int J Oral Surg 14:11–15

    Article  PubMed  CAS  Google Scholar 

  6. Bürger RA, Müller SC, el-Damanhoury H et al (1992) The buccal mucosal graft for urethral reconstruction: a preliminary report. J Urol 147(3):662–664

    PubMed  Google Scholar 

  7. Lauer G, Schimming R, Frankenschmidt A (2001) Intraoral wound closure with tissue-engineered mucosa: new perspectives for urethra reconstruction with buccal mucosa grafts. Plast Reconstr Surg 107:25–33

    Article  PubMed  CAS  Google Scholar 

  8. Wood DN, Allen SE, Andrich DE et al (2004) The morbidity of buccal mucosal graft harvest for urethroplasty and the effect of nonclosure of the graft harvest site on postoperative pain. J Urol 172:580–636

    Article  PubMed  CAS  Google Scholar 

  9. Rourke K, McKinny S, St Martin B (2012) Effect of wound closure on buccal mucosal graft harvest site morbidity: results of a randomized prospective trial. Urology 79(2):443–447

    Article  PubMed  Google Scholar 

  10. Song LJ, Xu YM, Hu XY, Zhang HZ (2007) Urethral substitution using autologous lingual mucosal grafts: an experimental study. BJU Int 101:739–743

    Article  PubMed  Google Scholar 

  11. Song LJ, Xu YM, Lazzeri M, Barbagli G (2009) Lingual mucosal grafts for anterior urethroplasty: a review. BJU Int 104(8):1052–1056

    Article  PubMed  Google Scholar 

  12. Barbagli G, Selli C, Tosto A, Palminteri E (1996) Dorsal free graft urethroplasty. J Urol 155:23–26

    Article  Google Scholar 

  13. Barbagli G, Selli C, di Cello V, Mottola A (1996) A one-stage dorsal free-graft urethroplasty for bulbar urethral strictures. Br J Urol 78:929–932

    Article  PubMed  CAS  Google Scholar 

  14. Andrich DE, Leach CJ, Mundy AR (2001) The Barbagli procedure gives the best results for patch urethroplasty of the bulbar urethra. BJU Int 88:385–389

    Article  PubMed  CAS  Google Scholar 

  15. Wessells H (2002) Ventral onlay graft techniques for urethroplasty. Urol Clin North Am 29:381–387

    Article  PubMed  Google Scholar 

  16. Armenakas NA (2004) Long-term outcome of ventral buccal mucosal grafts for anterior urethral strictures. AUA News 9:17–18

    Google Scholar 

  17. Al-Qudah HS, Santucci RA (2006) Buccal mucosal onlay urethroplasty versus anastomotic urethroplasty (AU) for short urethral strictures: which is better? J Urol 175:103

    Google Scholar 

  18. Guralnick ML, Webster GD (2001) The augmented anastomotic urethroplasty: indications and outcome in 29 patients. J Urol 165:1496–1501

    Article  PubMed  CAS  Google Scholar 

  19. Asopa HS, Garg M, Singhal GG et al (2001) Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach. Urology 58:657–659

    Article  PubMed  CAS  Google Scholar 

  20. Barbagli G, Guazzoni G, Lazzeri M (2008) One-stage bulbar urethroplasty: retrospective analysis of the results in 375 patients. Eur Urol 53:828–833

    Article  PubMed  Google Scholar 

  21. Barbagli G, Morgia G, Lazzeri M (2008) Retrospective outcome analysis of one-stage penile urethroplasty using a flap or graft in a homogeneous series of patients. BJU Int 102:853–860

    Article  PubMed  Google Scholar 

  22. Hayes MC, Malone PS (1999) The use of a dorsal buccal mucosal graft with urethral plate incision (Snodgrass) for hypospadias salvage. BJU Int 83:508–509

    Article  PubMed  CAS  Google Scholar 

  23. Engel O, Fisch M (2010) Harnröhrenrekonstruktion nach erfolgloser Primäroperation. Urologe A 49(7):822–826

    Article  PubMed  CAS  Google Scholar 

  24. Bhargava S, Patterson JM, Inman RD et al (2008) Tissue-engineered buccal mucosa urethroplasty-clinical outcomes. Eur Urol 53(6):1263–1269

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik und Poliklinik für Urologie, Universitätsklinik Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    O. Engel, S. Ahyai, M. Rink, C. Eichelberg, R. Dahlem & M. Fisch

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  1. O. Engel
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  2. S. Ahyai
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  3. M. Rink
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  4. C. Eichelberg
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  5. R. Dahlem
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  6. M. Fisch
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Correspondence to O. Engel.

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Engel, O., Ahyai, S., Rink, M. et al. Harnröhrenrekonstruktion unter Verwendung von Mundschleimhauttransplantaten. Urologe 52, 650–656 (2013). https://doi.org/10.1007/s00120-013-3117-5

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  • DOI: https://doi.org/10.1007/s00120-013-3117-5

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