[Use of buccal mucosa in urethral surgery]

Buccal mucosa grafts have proven reliable in urethral surgery. For augmentation urethroplasty, the graft can be used as a ventral or dorsal onlay. If the graft was used as an onlay, the results were much better than in substitution urethroplasty with the graft used as a tube. In patients with complex strictures or severe cases of hypospadias or epispadias, a two-stage technique using a buccal mucosa inlay graft can be applied. After 6 months, the well-revascularized buccal mucosa strip can be tubularized and covered with a tunica dartos or tunica vaginalis flap. In the future, for correction of larger defects, buccal mucosa cells can be cultured in vitro on biodegradable matrices. These larger buccal mucosa transplants could minimize the morbidity at the donor site. Future studies must clarify if the new technology of nanofibers can be of advantage by producing better matrices.