• IgG4 related disease
• Oral mucosal grafting
• amniotic membrane transplantation
• corneal melting
• dry eye disease

• diabetes mellitus
• urethral stricture
• penile diseases

• Humans
• Urethral Stricture/surgery
• Urethral Stricture/etiology
• Mouth Mucosa/transplantation
• Male
• Recurrence
• Risk Factors
• Urethra/surgery
• Urologic Surgical Procedures, Male/methods
• Treatment Outcome

• Constriction (pathologic)
• Elastic modulus
• Tensile strength
• Tissue engineering
• Ureter

• Animals
• Mouth Mucosa/physiology
• Ureter/physiology
• Tensile Strength
• Swine
• Biomechanical Phenomena
• Elastic Modulus
• Stress, Mechanical

• StAR MD 22260A01 Royal College of Surgeons in Ireland
• StAR MD 22260A01 Royal College of Surgeons in Ireland

• Humans
• Male
• Lens Implantation, Intraocular/adverse effects
• Aged
• Mouth Mucosa/transplantation
• Suture Techniques
• Treatment Outcome
• Visual Acuity
• Sclera/surgery
• Sclera/transplantation
• Amnion/transplantation
• Lenses, Intraocular
• Cataract Extraction

• electrospinning
• oral mucosa regeneration
• poly(tetrafluoroethylene)
• polymeric membranes
• vinylidene fluoride tetrafluoroethylene copolymer

• Disfunción eréctil
• Erectile dysfunction
• Erection function
• Estenosis uretral
• Función eréctil
• Urethral stricture
• Uretroplastia
• Uretroplasty

• Male
• Humans
• Adolescent
• Aged
• Urethra/surgery
• Urethral Stricture/surgery
• Urethral Stricture/etiology
• Retrospective Studies
• Constriction, Pathologic/etiology
• Urologic Surgical Procedures, Male/methods
• Anastomosis, Surgical

• penis
• tissue engineering
• urology

• 258229 CIHR

• buccal mucosal graft
• ileum
• lingual mucosal graft
• meta-analysis
• oral mucosa
• ureteric stricture
• ureteroplasty

• Humans
• Ureter/surgery
• Constriction, Pathologic/surgery
• Treatment Outcome
• Ureteral Obstruction/surgery
• Mouth Mucosa/transplantation
• Postoperative Complications/epidemiology

• Buccal mucosa
• Male urologic surgery
• Tunica albuginea
• Urethral stricture
• Urethroplasty

• Buccal graft
• closure
• non-closure
• urethral stricture
• urethroplasty

This study summarizes the short-term efficacy of the one-stage tubularized urethroplasty using the free inner in proximal hypospadias.

A retrospective analysis was conducted on 42 patients with proximal hypospadias. All cases were treated with one-stage tubularized urethroplasty from January 2020 to June 2021. The postoperative complications like urethral fistula, urethral stricture, diverticulum, and split penis head were recorded.

Patients were followed up for 3 to 15 months (an average of 8.5 months). A total of 26 cases (62%) were repaired without any complication. Five patients (11.9%) developed urinary fistulas and underwent secondary repair: three cases with anastomotic fistulas and two cases of coronal fistulas. Nine patients (21.4%) had stenosis of the head segment of the penis, six (14.3%) had stenosis that was relieved by urethral dilatation combined with topical mometasone furoate 1 month after urethral catheter removal. Two patients (4.8%) had severe stenosis with secondary surgical stenosis incision, and one (2.4%) had combined urethral diverticulum in which urethral stenosis incision and diverticulectomy were performed.

Tubularized urethroplasty using the free inner bears the advantages of easy access, reduced short-term complications, low incidence of diverticula.

Metoidioplasty is a variant of the gender affirmation technique neophalloplasty, where a hormonally enlarged clitoris is reconstructed to become a small penis. The goals of metoidioplasty are male appearance of the genitalia, voiding in standing position, and completely preserved erogenous sensation of the neophallus. However, it does not enable penetrative sexual intercourse due to the small dimensions of the neophallus. Basic principles of metoidioplasty were established 50 years ago, and many refinements of the technique have been reported since. The latest improvements are based on the advances in urethroplasty, perioperative care, and new insights into female genital anatomy. The current metoidioplasty technique is a one-stage procedure that includes vaginectomy, straightening and lengthening of the clitoris, urethral reconstruction by combined flaps and grafts, and scrotoplasty with insertion of testicular implants. Good aesthetic, functional, and psychosexual outcomes are achieved with this type of neophalloplasty.

Aminogam gel is used in human patients to accelerate the post‐surgical wound healing process of soft oral tissues (e.g. after teeth extraction or oral laser surgery). For this reason and because of the histological affinity between oral and genital mucosa, Aminogam Gel was applied on the dog's penile mucosa to evaluate wound healing after traumatic lesion.

This study aimed to compare conventional therapy (using only oral medications) to topic application of ‘Aminogam Gel’ in order to determine which is better to accelerate the healing process of canine penis injuries.

For this study, 12 male dogs with an injured penis and traumatic paraphimosis were selected. All patients had traumatic penis injuries due to unsuccessful mating attempts and consequent trauma (continuous licking). The dogs underwent surgical curettage of necrotic areas. The animals were randomly divided into two groups: a control group treated with routine therapy and a group treated with Aminogam Gel as an adjuvant for the scarring process. We assessed wound status and tracked healing using the Bates‐Jensen Wound Assessment Tool.

Dogs treated with Aminogam Gel therapy healed faster than dogs treated with traditional therapy alone.

Aminogam Gel is a valid auxiliary drug to accelerate wound healing after penis surgery. This is especially important for breeding dogs, for whom rapid and complete healing of the penis is important for returning to normal reproductive activities.

• Aminogam Gel
• canine penis
• injured penis
• surgical curettage

• Buccal mucosa graft
• hypospadias
• penile skin and dartos management

For the post-surgical treatment of oral wounds and mucosal defects beyond a certain size, the gold standard is still an autologous skin or mucosal graft in combination with complex suturing techniques. A variety of techniques and biomaterials has been developed for sutureless wound closure including different tissue glues or collagen patches. However, no wound covering that enables for sutureless fixation has yet been introduced. Thus, a new system was developed that allows for sutureless wound covering including a transparent collagen membrane, which can be attached to the mucosa using a specially modified 2λ laser beam with integrated temperature sensors and serum albumin as bio-adhesive. The sutureless wound closure system was tested for its applicability and its cytocompatibility by an established in vitro model in the present study. The feasibility of the laser system was tested ex vivo on a porcine palate. The in vitro cytocompatibility tests excluded the potential release of toxic substances from the laser-irradiated collagen membrane and the bio-adhesive. The results of the ex vivo feasibility study using a porcine palate revealed satisfactory mean tensile strength of 1.2–1.5 N for the bonding of the membrane to the tissue fixed with laser of 980 nm. The results suggest that our newly developed laser-assisted wound closure system is a feasible approach and could be a first step on the way towards a laser based sutureless clinical application in tissue repair and oral surgery.

• biocompatibility
• collagen membrane
• in vitro
• intraoral laser tissue soldering (LTS)
• sutureless wound closure

• Animals
• Biocompatible Materials/therapeutic use
• Cattle
• Cell Line
• Cell Proliferation
• Cell Survival
• Collagen/therapeutic use
• Equipment Design
• Feasibility Studies
• Laser Therapy/instrumentation
• Laser Therapy/methods
• Membranes, Artificial
• Mice
• Swine
• Temperature
• Wound Healing

• Collagen membrane
• inflammatory tissue response
• transparency
• wound healing

• Oral mucosa graft
• Patient-reported outcomes
• Questionnaire
• Urethroplasty

To report a single surgeon experience with one year follow-up after open ureteroplasty with buccal mucosa graft (OUBMG) in the rare situation of long segment proximal ureteral strictures.

Four patients with long segment proximal ureteral stricture underwent OU-BMG between February and July 2017. Functional outcome was assessed by pre- and postoperative serum creatinine, ultrasound and renal scintigraphy as well as patient reported outcomes.

Four patients with an average stricture length of 4 cm underwent OU-BMG between February and July 2017. No major postoperative complications occurred. Retrograde uretero-pyelography 6 weeks postoperatively revealed a watertight anastomosis followed by immediate emptying of the renal pelvis and ureter in all four patients. Ureteroscopy at this time showed a wide lumen with well-vascularized pink mucosa. After a mean follow-up time of 12.5 (12–14) months, postoperative serum creatinine was unimpaired. Renal scintigraphy revealed no signs of renal obstruction. With regard to intraoral surgery, no difficulties with mouth opening or intraoral dryness or numbness were reported.

For patients with long segment ureteral strictures OU-BMG is a safe technique with excellent surgical and functional outcomes. Hence, the application of this technique should be encouraged and regarded as one of the standard options in case of this rare problem.

• Radionuclide imaging
• Ureter

• International Prostate Symptom Score
• buccal mucosal graft
• lichen sclerosis
• lingual mucosal graft
• maximum urinary flow rate

• Clitoris
• female transgender
• gender-affirming surgery
• metoidioplasty
• outcomes

• Buccal mucosal graft
• eye
• minor salivary glands
• oral mucosal graft
• orbit

• Dry Eye Syndromes/surgery
• Humans
• Mouth Mucosa/transplantation
• Orbit/surgery
• Plastic Surgery Procedures
• Salivary Glands, Minor/transplantation
• Stevens-Johnson Syndrome/surgery

To describe the feasibility of a novel cell‐based endoscopic technique using buccal epithelium, expanded and encapsulated in a thermoreversible gelation polymer scaffold for the treatment of urethral stricture.

Six male patients with bulbar urethral stricture ranging from 2.0 to 3.5 cm in length were included in this pilot study. Autologous buccal epithelial cells from a small buccal mucosal biopsy were isolated, cultured and encapsulated in thermoreversible gelation polymer scaffold, and were implanted at the stricture site after a wide endoscopic urethrotomy.

All the patients voided well, with a mean peak flow rate of 24 mL/s. Urethroscopy carried out at 6 months showed healthy mucosa at the urethrotomy site. However, two of the six patients had recurrence at 18 and 24 months, respectively.

This endoscopic‐based Buccal epithelium Expanded and Encapsulated in Scaffold‐Hybrid Approach to Urethral Stricture (BEES‐HAUS) technique is a promising alternative for the open substitution buccal graft urethroplasty. It is possible to achieve the benefits of open substitution buccal urethroplasty with this endoscopic technique.

• buccal mucosa
• cell therapy
• scaffold
• urethral stenosis
• urethral stricture

• Clitoris
• female transgender
• metoidioplasty
• phalloplasty
• reconstruction

• Anterior urethral stricture
• Augmented anastomosis
• Bulbar urethral stricture
• One-stage repair
• Postoperative complications
• Reconstructive surgery

• buccal mucosal graft
• cleft lip palate
• nasal deformity
• rotational advancement
• secondary rhinoplasty

• Augmentation urethroplasty
• Fibrosis
• Tissue-engineered buccal mucosa
• Urethral strictures

• Adipose tissue
• mouth mucosa
• palate
• reconstructive surgical procedures
• transplantation

• Pediatric urethral trauma
• Urethral injuries
• Urethral reconstruction in children
• Urethroplasty

• ATMP
• Graft
• Oral mucosa
• Reconstruction
• Tissue engineering
• Urethra stricture

• Adult
• Aged
• Aged, 80 and over
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Mouth Mucosa/transplantation
• Postoperative Complications
• Proportional Hazards Models
• Plastic Surgery Procedures/adverse effects
• Plastic Surgery Procedures/methods
• Recurrence
• Risk Factors
• Tissue Engineering
• Transplantation, Autologous
• Treatment Outcome
• Urethral Stricture/pathology
• Urethral Stricture/surgery
• Young Adult

• Fibrovascular tube
• Neourethra
• Silicon catheter
• Urethral reconstruction

• Algorithm
• Conservative management
• Disorders of sex development
• Hypospadias
• Referral
• Timing of treatment
• Tissue engineering

• Disorders of Sex Development/diagnosis
• Humans
• Hypospadias/etiology
• Hypospadias/pathology
• Hypospadias/surgery
• Male
• Patient Satisfaction
• Penis/abnormalities
• Penis/surgery
• Plastic Surgery Procedures
• Urethra/abnormalities
• Urethra/surgery

• VU University Medical Center (VUmc)

• buccal mucosal grafts
• fasciocutaneous flaps
• phalloplasty

We report here the history and evolution of the use of oral mucosa in reconstructive urethral surgery since it was first used for urethroplasty in 1894. Since that time, many authors have contributed to develop, improve and popularize the use of oral mucosa as a substitute material. Paediatric urologists should be considered pioneers on the use of oral mucosa as they used it to repair primary and failed hypospadias. The use of oral mucosa to repair penile and bulbar urethral strictures was described, for the first time, in 1993. Important evolutions in the technique for harvesting oral mucosa from the cheek were reported in 1996. Today, oral mucosa is considered the gold standard material for any type of anterior urethroplasty in a one- or two-stage repair due to its biological and structural characteristics that make it a highly versatile that is adaptable to any environment required by the reconstructive urethral surgery. As the future approaches, tissue engineering techniques will provide patients with new materials originating from the oral epithelial mucosal cells, which are cultured and expanded into a scaffold. However, the path to reach this ambitious objective is still long and many difficulties must be overcome along the way.

• Cheek
• Oral mucosa
• Reconstructive urology
• Tissue engineering
• Urethra
• Urethroplasty

To assess the outcome of single stage dorsolateral onlay buccal mucosal urethroplasty for long anterior urethral strictures (>4cm long) using a perineal incision.

From August 2010 to August 2013, 20 patients underwent BMG urethroplasty. The cause of stricture was Lichen sclerosis in 12 cases (60%), Instrumentation in 5 cases (25%), and unknown in 3 cases (15%). Strictures were approached through a perineal skin incision and penis was invaginated into it to access the entire urethra. All the grafts were placed dorsolaterally, preserving the bulbospongiosus muscle, central tendon of perineum and one-sided attachement of corpus spongiosum. Procedure was considered to be failure if the patient required instrumentation postoperatively.

Mean stricture length was 8.5cm (range 4 to 12cm). Mean follow-up was 22.7 months (range 12 to 36 months). Overall success rate was 85%. There were 3 failures (meatal stenosis in 1, proximal stricture in 1 and whole length recurrent stricture in 1). Other complications included wound infection, urethrocutaneous fistula, brownish discharge per urethra and scrotal oedema.

Dorsolateral buccal mucosal urethroplasty for long anterior urethral strictures using a single perineal incision is simple, safe and easily reproducible by urologists with a good outcome.

This is a prospective study of the use and efficacy of a novel technique of circumferential tubularised lingual mucosal graft (LMG) in obliterative and near obliterative bulbar urethral stricture of >2 cm where excisional and augmented anastomotic urethroplasty are not feasible.

The stenotic urethral segment was opened dorsally in midline and fibrosed urethra was excised taking care to preserve the healthy spongiosum tissue. LMG (av. Length 3 cm) was placed from one end of corporal body towards spongy tissue in a circumferential manner. Another LMG was placed in similar manner to deal with longer stricture. The urethra was tubularised over 14 Fr silicone catheter.

A total of 12 men, of mean age 47 years underwent this procedure. The mean follow up period was 11 months starting from July 2014 till manuscript submission. Follow up included voiding cystourethrogram at 3 weeks, cystoscopy at 3 months (one patient didn’t turned up) and subsequent follow up. Mean stricture length was 4.66 cm (range, 3–8.5 cm) and mean operative time was 195 min. (range, 160 to 200 min.). The technique was successful (normal voiding with no need for any post-operative procedure) in 11(91.6%) patients. One patient developed early recurrence at 4 month of surgery and had anastomotic stricture which was successfully managed by direct visual internal urethrotomy.

Single stage circumferential tubularised graft urethroplasty is an excellent technique for strictures that include segments of obliterative and near obliterative diseased urethra. It provide a wider neourethra than patch graft urethroplasty.

• Circumferential
• lingual mucosal graft
• obliterative
• urethral stricture

The anatomy of the penile urethra presents additional challenges when compared to other urethral segments during open stricture surgery particularly because of its unsuitability for excision and primary anastomosis and its relatively deficient corpus spongiosum. Stricture aetiology, location, length and previous surgical intervention remain the primary factors influencing the choice of penile urethroplasty technique. We have identified what we feel are the most important challenges and controversies in penile urethral stricture reconstruction, namely the use of flaps vs grafts, use of skin or oral mucosal tissue for augmentation/substitution and when a single or a staged approach is indicated to give the best possible outcome. The management of more complex cases such as pan-urethral lichen-sclerosus strictures and hypospadias “cripples” is outlined and potential developments for the future are presented.

• Reconstructive surgical procedures
• Anterior urethral stricture
• Oral mucosa
• Tissue transplants
• Skin grafting
• Hypospadias
• Lichen sclerosus

The objective of the study was to compare the outcome of buccal and lingual mucosa graft (LMG) augmentation urethroplasty along with donor sites morbidities in anterior urethra stricture.

From September 2010 to January 2014, 125 patients underwent single stage augmentation urethroplasty. They were randomly divided into two groups to receive either buccal mucosa graft (BMG) or LMG. The patients were prospectively followed for complications and outcome.

Baseline characteristics such as mean age, etiology, stricture length, and location were comparable in both groups. Overall success rate for Group 1 and Group 2 were 69.2% and 80%, respectively. Mean follow-up periods were 28.2 and 25 months in Group 1 and Group 2, respectively.

LMG provides the better outcome with fewer immediate and delayed complications as compared to BMG. The length of stricture and width of graft were main factors affecting the outcome.

• Augmentation
• buccal
• lingual
• urethral stricture
• urethroplasty

• Hypospadias
• children
• grafts
• urethroplasty
• ventral curvature (VC)

• anterior urethral stricture
• urethral reconstruction
• urethroplasty