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Die Verwendung von Mundschleimhaut in der Harnröhrenchirurgie

Use of buccal mucosa in urethral surgery

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Zusammenfassung

Das freie Mundschleimhauttransplantat hat in der Harnröhrenchirurgie seinen festen Platz. Es wird in ventraler oder dorsaler Onlaytechnik erfolgreich angewandt. Im Vergleich zur Verwendung eines tubularisierten Mundschleimhautstreifens sind die Erfolgsraten deutlich besser. Bei Patienten, bei denen die einzeitige Rekonstruktion nicht sinnvoll erscheint, wird ein Mundschleimhautinlay verwendet, das nach 6 Monaten gut vaskularisiert ist und tubularisiert werden kann.

Zur Korrektur größerer Defekte kann es in Zukunft möglich sein, epitheliale Zellen auf resorbierbaren Matrices in vitro zu kultivierten und durch ein so gewonnenes autologes Mundschleimhauttransplantat auch die Morbidität an der Donorseite zu minimieren. Ob bei der Erstellung dieser Matrices die Nanofasertechnologie Vorteile bringt, müssen zukünftige Studien zeigen.

Abstract

Buccal mucosa grafts have proven reliable in urethral surgery. For augmentation urethroplasty, the graft can be used as a ventral or dorsal onlay. If the graft was used as an onlay, the results were much better than in substitution urethroplasty with the graft used as a tube. In patients with complex strictures or severe cases of hypospadias or epispadias, a two-stage technique using a buccal mucosa inlay graft can be applied. After 6 months, the well-revascularized buccal mucosa strip can be tubularized and covered with a tunica dartos or tunica vaginalis flap.

In the future, for correction of larger defects, buccal mucosa cells can be cultured in vitro on biodegradable matrices. These larger buccal mucosa transplants could minimize the morbidity at the donor site. Future studies must clarify if the new technology of nanofibers can be of advantage by producing better matrices.

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  1. Urologische Klinik und Poliklinik, Klinikum der Johannes-Gutenberg-Universität, Langenbeck-Straße 1, 55131, Mainz, Deutschland

    R. Stein, A. Schröder & J.W. Thüroff

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  1. R. Stein
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  2. A. Schröder
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  3. J.W. Thüroff
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Correspondence to R. Stein.

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Stein, R., Schröder, A. & Thüroff, J. Die Verwendung von Mundschleimhaut in der Harnröhrenchirurgie. Urologe 46, 1657–1663 (2007). https://doi.org/10.1007/s00120-007-1587-z

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