Summary
Purpose
Lower lip and cheek are commonly used sources of buccal mucosa grafts for urethroplasty.
In recent years, aiming to improve the donor site morbidity, our preference changed
to the use (ULG). The aim of this video is to illustrate the technical details of
the ULG harvesting for children.
Material and methods
The inner surface of the upper lip is exposed by two stay sutures. The frenulum is
spared, the mucosa to be harvested is marked and local submucosal infiltration is
done with a solution of bupivacaine plus epinephrine. The edges are incised ant the
submucosa plane created with a scissor. The graft is detached, defatted, and applied
with quilting stitches over the recipient site with the standard technique. Hemostasis
is secured and the donor site is left open.
Results
From 2015 to 2018, 25 ULG harvests were done in 24 patients. Only one (5%) presented
local pain associated to the procedure in the first 24 h. After minimum 2 months after
surgery, none of the patients presented perioral nubmness, difficulty with mouth opening,
contraction of the donor site or changes in salivation.
Conclusions
ULG harvest is easy and a suitable alternative source of oral mucosa for urethroplasty
in children.
Keywords
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References
- Failed hypospadias in paediatric patients.Nat Rev Urol. 2013 Nov; 10: 657-666
- Critical outcome analysis of staged buccal mucosa graft urethroplasty for prior failed hypospadias repair in children.J Urol. Mar 2011; 185: 1077-1082
- Proximal hypospadias: a persistent challenge. Single institution outcomeanalysis of three surgical techniques over a 10-year period.J Pediatr Urol. 2016; 12 (28.e1e28.e7)
- Donor-site morbidity in buccal mucosa urethroplasty: lower lip or inner cheek?.BJU Int. 2005; 96: 619-623
- Lingual mucosal graft two-stage Bracka technique for redo hypospadias repair.Arab J Urol. 2017 Jul 19; 15: 236-241
Article info
Publication history
Published online: July 01, 2020
Accepted:
June 25,
2020
Received in revised form:
June 17,
2020
Received:
May 6,
2020
Identification
Copyright
© 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
