title: Lingual mucosal graft urethroplasty for anterior urethral reconstruction.
abstract: OBJECTIVE
  Evaluate the use of lingual mucosal graft (LMG) in anterior urethral strictures.
  
  
  METHODS
  From January 2001 to December 2006, 29 men (mean age, 48.5 yr) with anterior urethral strictures underwent graft urethroplasty with LMG. The mean length of stricture was 3.6cm. Patients with bulbar, penile, or bulbopenile strictures received one-stage dorsal free graft urethroplasties. In patients with failed hypospadias repair we performed a two-stage urethroplasty. Criteria for successful reconstruction were spontaneous voiding with no postvoid residual urine and no postoperative instrumentation of any kind. Clinical assessment included the donor site morbidity.
  
  
  RESULTS
  Mean follow-up was 17.7 mo. One-stage bulbar and penile urethroplasties without meatal involvement had an 81.8-100% success rate. Bulbopenile urethroplasties were successful in 60% of the cases, whereas one-stage urethral reconstructions in patients with meatal involvement were successful in 66.6%. The two cases of two-stage urethral reconstruction with LMG and buccal mucosal graft after failed multiple hypospadias repairs were unsuccessful. The overall early recurrence rate was 20.7%. Patients with the graft harvested from the tongue reported only slight oral discomfort at the donor site and difficulty in talking for 1 or 2 d.
  
  
  CONCLUSIONS
  The mucosa of the tongue, which is identical to the mucosa of the rest of the oral cavity, is a safe and effective graft material in the armamentarium for urethral reconstruction with potential minor risks of donor site complications. LMG may be used alone for short strictures (<5cm) or in combination with buccal mucosa when longer grafts are needed.
authors.affiliation: Luciano Giuliani Department of Urology, University of Genoa, Genoa, Italy. alchiede.simonato@unige.it
authors.forename: Alchiede
authors.initials: A
authors.lastname: Simonato
authors.forename: Andrea
authors.initials: A
authors.lastname: Gregori
authors.forename: Carlo
authors.initials: C
authors.lastname: Ambruosi
authors.forename: Fabio
authors.initials: F
authors.lastname: Venzano
authors.forename: Virginia
authors.initials: V
authors.lastname: Varca
authors.forename: Andrea
authors.initials: A
authors.lastname: Romagnoli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Carmignani
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D014059:Tongue / Q000637:transplantation*; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*