The True Oral History of Buccal Mucosal Grafts for Male Urethral Stricture Repair

To record the history of the adoption and utilization of the surgical technique of buccal mucosal grafts for urologic procedures.

Academic and historic medical articles available on PubMed and open search engines were reviewed for information linked to physicians who have utilized buccal mucosal grafts from 1894 to 2021.

In the late 19th and early 20th centuries, oral grafts were primarily used by ophthalmologists. Dr. Kirill Sapezhko was the pioneering urologist who applied this surgical technique for urethral stricture disease, publishing his case series in 1894. Almost 50 years later in 1941, Dr. Graham Humby in London published a case report on the use of oral mucosa for treatment of hypospadias in an 8-year-old patient. There was then a large gap in reports for several decades. Articles commonly recognized as milestone publications do not appear until 1992 from Dr. R. A. Bürger in Germany and Dr. Antonio Dessanti in Italy. Literature involving buccal mucosal grafts then expanded exponentially, and it has become the gold standard for anterior urethral stricture repair.

The literature inconsistently recognizes Dr. Sapezhko's innovation of oral mucosal grafts in urethral stricture repair. The history of oral mucosal grafts highlights how knowledge can be lost for periods of time, which can cause lack of widespread acknowledgment of the origin of surgical techniques.