Combined Buccal and Bladder Mucosa for Staged Urethral Reconstruction

Abstract

Combined buccal and bladder mucosa represents the only reconstructive solution for panurethral strictures by Lichen Sclerosus (LS) in which the need to remove the diseased urethral mucosa and to reconstruct a long and circumferential urethral tract, collides with the limit of buccal mucosa harvesting and with the lack of others substitutive tissues not lichen involved. The use of buccal mucosa for glandular urethral reconstruction avoids the direct contact of the bladder mucosa with the air and, therefore its drying-retraction-stenosis. The bladder mucosa tube is covered and supported by residual urethral spongiosum that has been saved during the phase of diseased urethral mucosa removal. The described technique is the only reconstructive chance in severe panurethral strictures by LS. In these cases the alternative would be the definitive urethral perineal stomy.