The Impact of Preoperative Oral Health on Buccal Mucosa Graft Histology.
PURPOSE: Previous studies have elucidated the unique macroscopic and histological properties of buccal mucosa that make it a viable and durable graft for urethral augmentation. However, no prior literature has directly investigated the impact of preoperative oral health on these features.
MATERIALS AND METHODS: We analyzed all consenting patients who underwent buccal mucosal graft (BMG) urethroplasty at our institution from 2018 to 2020. Validated oral health surveys, the Oral Health Impact Profile (OHIP-14) and the Kayser-Jones Brief Oral Health Status Examination (BOHSE) were completed preoperatively. A staff pathologist analyzed BMG histology and quantified oral mucositis using a modified Oral Mucosa Rating Scale.
RESULTS: We analyzed 51 patients with a median age of 40 years (IQR 31-58). Mean BOHSE score was 1.1 and OHIP-14 score was 1.4. Median epithelial thickness was 530 μm and lamina propria thickness was 150 μm. On age-adjusted analysis, increasing BOHSE and OHIP-14 were associated with decreasing epithelial thickness (p values
CONCLUSIONS: This is the first study to demonstrate that oral health conditions impact graft histology and stretch. Although much remains to be learned, our findings shed light on the potential importance of optimizing oral health prior to BMG urethroplasty, and raise the question of if preoperative mucosal biopsy could help inform surgical decision making and discussions regarding surgical success.
Published In/Presented At
Kurtzman, J. T., Sukumar, S., Pan, S. M., Mendonca, S., Lai, Y., Pagan, C. A., & Brandes, S. B. (2021). The Impact of Preoperative Oral Health on Buccal Mucosa Graft Histology. The Journal of urology, 206(3), 655–661. https://doi.org/10.1097/JU.0000000000001829
Medicine and Health Sciences
Department of Medicine