Histopathological changes in oral mucosa in cases of failed augmented urethroplasty

Özet

Objective: Histopathological changes in oral (buccal or lingual) mucosa after exposure to urine are still notcompletely understood. We evaluated these changes in free oral mucosal graft integrated in human urethra.Material and methods: Total 19 patients with recurrent urethral stricture after oral mucosa urethroplasty(buccal 12 and lingual 7) were prospectively evaluated. Intraoperatively integrated buccal or lingual mucosal graft sample that was previously engrafted to urethra was completely excised along with healthy oralmucosa, and it was sample processed for histopathological evaluation by dedicated pathologist. Preoperativeclinical data were properly collected from all the study participants.Results: The mean age of the patients was 30 years, and the mean preoperative peak flow rate was 4.2 mL/s.Etiology of initial stricture was idiopathic in 13 (68.42%) patients and traumatic urethral catheterizationin 6 (31.58%) patients. Mean interval from previous buccal mucosal urethroplasty to current urethroplastywas 21.9 months (range 12-46 months). On repeat urethroplasty, the mean stricture segment length was 59.2(38-77) mm [60.08 (38-74.6) mm buccal, and 58.32 (39.6-77) mm lingual]. These integrated oral mucosalgrafts maintained their histopathological characteristics in all patients except some kind of changes likesubmucosal fibrosis in seven (58.33%) cases of buccal and vacuolar degeneration in five (71.42%) cases oflingual mucosal urethroplasty.Conclusion: Histopathological characteristics of integrated oral (buccal and lingual) mucosal grafts weremaintained even on exposure to urine except some changes like submucosal fibrosis and vacuolar degeneration. Impact of these changes require further research.