Comparison of donor site intraoral morbidity after mucosal graft harvesting for urethral reconstruction.
OBJECTIVE
To compare postoperative intraoral morbidity after mucosal graft harvesting from the lower lip and inner cheek in men undergoing substitution urethroplasty.


METHODS
From 2000 to 2004, 40 patients underwent oral mucosal graft harvesting for urethral reconstruction. Of the 40 patients, 17 underwent harvest from the lower lip (group 1), 19 from the inner cheek (group 2), and 4 from both sites (group 3). We analyzed the postoperative differences in discomfort levels, neurosensory deficits, salivary flow, complications, and overall quality of life according to harvest site. Outcomes were assessed using analog scales and a questionnaire.


RESULTS
At longer term follow-up, the proportion of men with persistent postoperative discomfort, neurosensory deficits, and changes in salivary flow was greater in men whose grafts were harvested from the lower lip than in those whose grafts were harvested from the cheek. Contractures were noted in 1 (5.9%) of 17 and 5 (26.3%) of 19 men in groups 1 and 2, respectively. At the last follow-up visit, overall quality of life (measured by an analog scale of 0 [delighted] to 6 [terrible]) was not significantly different in patients with lower lip versus inner cheek harvest (1.35 versus 0.66, respectively, P = 0.079).


CONCLUSIONS
Persistent postoperative discomfort, neurosensory deficits, and salivary flow changes were more common in men whose grafts were harvested from the lower lip. However, the overall quality of life in this group was not significantly different compared with men whose grafts were harvested from the inner cheek. From a morbidity standpoint, the inner cheek appears to be the preferable site of graft harvest.
Jang
Thomas L
TL
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Erickson
Bradley
B
Medendorp
Andrew
A
Gonzalez
Chris M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002610:Cheek; D006801:Humans; D008046:Lip; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology* / Q000209:etiology; D009061:Mouth Mucosa / Q000637:transplantation*; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012472:Salivation; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014521:Urethra / Q000601:surgery*