Morbidity associated with oral mucosa harvest for urological reconstruction: an overview

To present a systematic review of the literature regarding complications associated with the donor site following oral mucosa harvest for urethral reconstruction.

The authors conducted a database search for relevant literature during the time period January 1966 through January 1, 2007, regarding complications associated with oral mucosa graft harvest for use in urethral transplantation. Bibliographies of database hits were searched for pertinent papers.

The most common harvest sites were the buccal and mandibular labial mucosa. The most frequent complications at both mucosal harvest sites were scarring and contracture. These 2 complications limit jaw opening and have been found to last for as long as 4 weeks. Labial mucosa harvest is associated with the additional morbidity of perioral neurosensory defect because of the procedure's proximity to the mental nerve. When nerve damage occurs, it usually subsides within 10 months postsurgery. Patients report relatively the same quality of life following harvest from both donor sites, although buccal mucosa harvest was associated with less postoperative discomfort, less neurosensory defect, and less salivary flow change. Following oral mucosa harvest, patients should be able to ingest oral fluids within 24 hours, solid foods within 2 days, and return to a normal dietary regimen within 1 week of harvest.

When harvesting oral mucosa for urethral reconstruction, sound surgical principles will ensure the patient the best chance of avoiding postoperative complications at the donor site. Oral and maxillofacial surgeons should advise both urologists and their patients of the potential complications associated with both oral mucosa harvesting sites.