HARVESTING BUCCAL MUCOSA UNDER LOCAL ANESTHESIA – FEASIBILITY AND ACCEPTANCE FOR SUBSTITUTION URETHROPLASTY

Abstract

ABSTRACT Background: The management of male urethral strictures is complex. In recent years, open reconstruction using a buccal graft has become the preferred primary treatment modality over repeated minimally invasive options. Hereby we describe the feasibility and safety of buccal mucosa harvest under local anesthetic agent infiltration for urethroplasty. Materials and methods: We retrospectively analyzed all patients who underwent open urethral reconstruction graft surgery with buccal mucosa harvest under local anesthesia between October 2013 and September 2020. Demographic data of the patients, length of the graft needed for urethroplasty, pain during and after the harvest, donor site complications were considered and analyzed. Results: During this period 18 male patients with anterior urethral strictures underwent open urethral reconstruction using a buccal mucosa graft harvested under local anesthesia. All procedures were done by a single surgeon, except in three cases were a buccal nerve block was used to anesthetize the soft tissues and periosteum buccal to the mandibular molars. The mean harvested graft length was 4.81 cm (+-2.8 cm) and the mucosa was closed after harvesting. There was no need for general anesthesia. Sixteen patients (88.88%) reported that it was “easy” to maintain the mouth open during the procedure. In all of them except in one, there was no significant pain present during or after the harvest. Only one patient reported a donor site hematoma after the procedure that required gauze packaging. Conclusion: Buccal mucosa harvest under local anetshesia is feasable, save and acceptable for the patients who underwent urethroplasty for urethral stricture disease.