Urologic Survey (Reconstructive Urology)

In the last few years in urethral defect reconstruction, in-mouth...

J Urol Surg 2014;1(1):49-49

EDITORIAL COMMENT In the last few years in urethral defect reconstruction, in-mouth mucosa is considered to be the most important donor tissue. Most frequently used parts for that purpose are mandibular labial alveos and intra mouth mucosa (buccal, BM) even more often. When literature is analysed; BM, which allows to take graft perfectly because of thick epitel and thin lamina, is used succesfully in urethral stricture, lichen sclerosis, hypospadias, epispadias and re-do urethral surgicals. But, discussions about morbidity of the donor part in the buccal mucosa of which graft is taken is still resuming. In this study, Wang et al. randomised patients into 2 groups on research the effect of closure of donor part after graft is taken. It is stated that graft is taken as 2 cm width, at a length determined according to necessity and in an oviform shape, as astandart. Patients whose graft beds were primarily closed were group 1, and patients that were left to recover without closure were group 2. Results were assessed with visual analog scale at early and late postoperative stages with regards to 5 different features (pain, numbness, tightness, functions of eating and drinking) that will determine morbidity. According to the results of the 34 patients that has completed the study, differences in pain and in functions of eating and drinking were determined at the 1. and 3. days postop, but in the late period until 1 year, non of these criteria showed any differances among the second group. With this study, closure of graft beds’ importance in terms of early period pain and oral nutrition has come clear. Randomise controlled study of Wong et al. has done is important because of it’s long follow-up, different than the others. The shape and especially the width of the graft being standardised is remarkable. While interpreting the study, it should not be ommited that due to its possibility to create strechness during closure, grafts that are taken wider and square shaped can lead to different results. Oktay Demirkesen MD