Comparative histological analysis of different materials used for urethroplasty in children with proximal forms of hypospadias: preputial skin vs buccal mucosa


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Abstract

Aim: Buccal mucosa and preputial skin grafts are used for staged urethroplasty in proximal forms of hypospadias in children. Aim of our study was to carry out a comparative histological analysis of preputial skin and buccal mucosa. Methods and materials: Histological analysis of urethral tissue samples from 10 patients with proximal forms of hypospadias was conducted. All patients were treated with staged Bracka’s technique using free grafts at the Russian Children’s Clinical Hospital from 2013 to 2016. Patients were divided into two groups. In Group I (n=5), preputial skin graft was used for urethroplasty, while in Group II (n=5) buccal mucosa was taken. A histological study of both materials with comparison to a native urethra was performed. Results: In Group I, the histological analysis showed keratinizing multilayered squamous epithelium, large number of dilated sweat and sebaceous glands with signs of inflammation, and hair follicles. In Group II, histological analysis revealed the presence of the typical structure for mucosal tissue, including multilayered flat nonkeratinizing epithelium, as well as full absence of sweat, sebaceous glands, and hair follicles. Conclusion: comparative histological analysis of neourethra has shown the absence of sweat and sebaceous glands, hair follicles, and areas of chronic inflammation in buccal mucosa vs preputial skin, showing that buccal mucosa is more similar to native urethra. Therefore, buccal mucosa is favored as the material for urethroplasty.

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About the authors

G. V Kozyrev

Russian Children’s Clinical Hospital

Email: kozgerman@mail.ru
MD-PhD, urologist and andrologist, Department of Uroandrology Moscow, Russia

D. T Manasherova

Moscow State University

Email: dm3097@columbia.edu
student at the Faculty of Fundamental Medicine Moscow, Russia

G. A Abdulkarimov

Russian Children’s Clinical Hospital

Email: gamzat1484@gmail.com
urologist and andrologist, Department of Uroandrology Moscow, Russia

B. L Kushnir

Russian Children’s Clinical Hospital

Email: kushnir.berta@gmail.com
pathologist, Department of Pathologic Anatomy Moscow, Russia

F. K Abdullaev

Russian Children’s Clinical Hospital

Email: afkrdkb@mail.ru
MD-PhD, Head of the Department of Uroandrology Moscow, Russia

V. V Nikolaev

Russian Children’s Clinical Hospital

MD-PhD, Professor, Head of the Surgical Department No2 Moscow, Russia

M. A Gazimiev

I.M. Sechenov First Moscow State Medical University

Email: gazimiev@yandex.ru
MD-PhD, professor, Director of the Institute of Electronic Medical Education of Sechenov University, Deputy Director on Educational work of the Research Institute for Urology and Human Reproductive Health of I.M. Sechenov First Moscow State Medical University, Deputy Director and Executive Director of the Russian Society of Urology (ROU) Moscow, Russia

References

  1. Angela M. et al. Buccal Mucosal Graft Urethroplasty. The ScWJ 2010;10:74-79.
  2. Barbagli G., Palminteri E., Rizzo M. Dorsal onlay graft urethroplasty using penile skin or buccal mucosa in adult bulbourethral strictures. J. Urol 1998;160.
  3. Bracka A. A long-term view of hypospadias. Br J Plast Surg 1989;42: 251-255.
  4. Bracka A. Hypospadias repair: the two-stage alternative BJU 1976:31-41.
  5. Bhargava S. Chapple C.R. Buccal mucosal urethroplasty: is it the new gold standard? BJU Int. 2004;93(9):1191-1193.
  6. Pippi Salle J.L., Sayed S., Salle A., Bagli D., Farhat W., Koyle M. et al. Proximal hypospadias: a persistent challenge. Single institution outcome analysis of three surgical techniques over a 10-year period. J Pediatr Urol 2016;12(1):28.1-7.
  7. Snodgrass W., Bush N. Tubularized incised plate proximal hypospadias repair: continued evolution and extended applications. J Pediatr Urol. 2011;7:2-9.
  8. Humby G.A. A one-stage operation for hypospadias. Br J Surg. 1941;29: 84-92.
  9. Burger R.A., Muller S.C., el-Damanhoury H., Tschakaloff A, Riedmiller H., Hohenfellner R. The buccal mucosal graft for urethral reconstruction: a preliminary report. J Urol. 1992;147:662-664.
  10. Duckett John W. Buccal mucosal urethral replacement. J Urol 1995;153:1660-1663.
  11. Geovanne F. Souza et al, Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits. International Braz J Urol. 2008;34(3):345-354.
  12. Abdorasol M. et al. Buccal Mucosal Graft in Repeat Urethroplasty. J Urol 2005;4:206-210.
  13. Barbagli G., Sansalone S., Djinovic R., Lazzeri M. Surgical Repair of Late Complications in Patients Having Undergone Primary Hypospadias Repair during Childhood: A New Perspective. Adv Urol. 2012;2012:705212.

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