The oral mucosa graft: a systematic review.
OBJECTIVE
We provide the reader with a critical, nonbiased, systematic review of current and precedent literature regarding the use of oral mucosa in the reconstruction of urethral defects associated with stricture and hypospadias/epispadias.


METHODS
We reviewed pertinent English literature from January 1966 through August 1, 2006 via the databases MEDLINE/PubMed, the Cochrane Library, and EMBASE Drugs and Pharmacology regarding the use of oral mucosa graft urethroplasty in the reconstruction of urethral defects associated with stricture and hypospadias/epispadias. Bibliographies of pertinent articles were explored for additional important literature.


RESULTS
Data were stratified among studies that only used oral mucosa graft urethroplasty in the reconstruction of urethral defects associated with stricture, and those that used oral mucosa graft urethroplasty in the reconstruction of urethral defects associated with hypospadias/epispadias. Recipient site success in the reconstruction of defects associated with stricture was significantly associated with the location of graft placement (ventral vs dorsal, p <0.001) when an onlay graft was used. Hypospadias/epispadias recipient site success was significantly associated with the type of graft used (tube vs onlay, p <0.001), and by the site of oral mucosa harvest (labial vs buccal, p <0.001). Other perioperative and patient oriented variables were not significantly associated with success at the recipient site.


CONCLUSIONS
The oral mucosa is a viable source of donor tissue displaying many characteristics of the ideal urethral graft. There are numerous variations of the oral mucosa graft urethroplasty technique. Herein comparisons are made.
Markiewicz
Michael R
MR
School of Dental Medicine, University at Buffalo, Buffalo, New York, USA. michaelmarkiewicz@gmail.com
Lukose
Melissa A
MA
Margarone
Joseph E
JE
Barbagli
Guido
G
Miller
Kennon S
KS
Chuang
Sung-Kiang
SK
D004842:Epispadias / Q000601:surgery*; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D012086:Reoperation; D013524:Surgical Flaps; D014525:Urethral Stricture / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology