Publication: Feasibility, Safety and Acceptance of Buccal Mucosa Harvest Under Local Anesthesia for Substitution Urethroplasty: Prospective Observational Study in a Tertiary Centre
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Urethral stricture is a challenging condition with significant socioeconomic impacts,
often requiring surgical intervention such as urethroplasty. Buccal mucosa grafts
(BMG) are a popular choice for substitution urethroplasty due to their favorable
outcomes. This study evaluates the feasibility, safety, and acceptance of harvesting
buccal mucosa grafts under local anesthesia.
Objective
To assess feasibility, safety and acceptance of Buccal mucosa harvest under local
anesthesia.
Method
A prospective observational hospital based study to evaluate outcomes of substitution
urethroplasty using buccal mucosa grafts (BMG) under local anesthesia.
Result
Of the 40 patients, 28 had unilateral graft harvests, while 12 had bilateral procedures.
The mean graft length obtained was 5.65 cm. Postoperatively, patients experienced
a quick recovery, with full mouth opening achieved within an average of 2.78 days
and resumption of normal eating within 2.6 days. Minor complications included
oral swelling in 15% of cases and food residue in 12.5%. Although 87.5% of patients
reported pain at the perineal wound site, the overall pain score averaged 3.58,
indicating manageable discomfort. Importantly, 92.5% of patients expressed a
willingness to undergo the procedure again if necessary.
Conclusion
These findings suggest that buccal mucosa graft harvest under local anesthesia is
both feasible and well-tolerated. The procedure appears to be a safe alternative to
regional or general anesthesia, with minimal complications and a high level of patient
acceptance. Future randomized controlled trials comparing local anesthesia to
regional or general anesthesia could provide additional insights and further validate
these findings. This study contributes to the growing body of evidence supporting
the use of local anesthesia in urethral stricture surgery, offering a practical approach
to managing this condition effectively.
KEY WORDS
Buccal mucosa graft, Feasibility study, Local anesthesia, Substitution urethroplasty,
Urethral stricture
Description
Pandey A, Shrestha PM, Shrestha A, Basnet RB, Adhikari B, Shah AK, Mishra U
Department of Urology
Bir Hospital, National Academy of Medical Sciences
Kathmandu, Nepal
Keywords
Buccal mucosa graft, Feasibility study, Local anesthesia, Substitution urethroplasty, Urethral stricture