FR01-13 THE EVOLUTION OF COLONIC MUCOSA USE IN URETHRAL RECONSTRUCTION

Abstract

You have accessJournal of UrologyHistory of Urology Forum I (FR01)1 Apr 2020FR01-13 THE EVOLUTION OF COLONIC MUCOSA USE IN URETHRAL RECONSTRUCTION Elizabeth Pagura*, Jaime Cavallo, Alexander Rozanski, Leonard Zinman, and Alex Vanni Elizabeth Pagura*Elizabeth Pagura* More articles by this author , Jaime CavalloJaime Cavallo More articles by this author , Alexander RozanskiAlexander Rozanski More articles by this author , Leonard ZinmanLeonard Zinman More articles by this author , and Alex VanniAlex Vanni More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000850.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Oral mucosa graft urethroplasty was first described by the Ukrainian surgeon Kirill Sapezhko in 1894. His protégé, I.A. Thyrmos, pioneered substitution urethroplasty with rectal mucosa and published its first use in 1902. We describe the poorly known evolution of colonic mucosa use in urethral reconstruction to its modern-day resurgence. METHODS: PubMed, the Journal of Urology archives, and the Hirsch Medical Library at Tufts University were all systematically queried for any combination of the terms “colonic mucosa”, “rectal mucosa”, “urethroplasty”, and “urethral reconstruction”. All literature matches were reviewed to construct the chronology of colonic mucosa use in urethral reconstruction. RESULTS: Thyrmos’ initial description of rectal mucosa graft urethroplasty in the Eastern scientific literature in 1902 failed to gain the attention of the Western scientific community. Brief mention of rectal mucosa as “yield[ing] some results” for urethral repair in an abstract from the 1918 Urologic Congress in Paris indicates international communication, but lack of concept adoption. Descriptions of urethroplasty using colonic mucosa grafts did not appear again in the medical literature until Paul Mitofanoff of France published his work with colonic mucosa grafts in rats in 1994. Between 2002 and 2009, Yue-Min Xu et al of China applied the concept of colonic mucosa grafts to long-segment, complex urethral reconstruction in which oral mucosa grafts were inadequate in length or unavailable. Their preclinical studies in a dog model and subsequent clinical series achieved colonic mucosa grafts up to 21 centimeters (cm) in length, but required concurrent bowel resection. In 2016, Vanni et al described the first minimally invasive harvest of rectal mucosa grafts up to 15 cm in length for long-segment urethral reconstruction using a transanal endoscopic microsurgical (TEM) technique. This approach circumvented the need for bowel resection and minimized associated gastrointestinal morbidity. In 2019, this was expanded upon in a multi-institutional study by Granieri et al by including a wider variety of minimally invasive graft harvest techniques with either TEM or robotic transanal minimally invasive surgery (R-TAMIS). CONCLUSIONS: Colonic mucosa use in urethral reconstruction has been described in urologic literature for nearly as long as oral mucosa use. Modern-day literature highlights that it remains a viable alternative graft option with minimal donor site morbidity, especially in the era of minimally invasive tissue harvest techniques. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e288-e289 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elizabeth Pagura* More articles by this author Jaime Cavallo More articles by this author Alexander Rozanski More articles by this author Leonard Zinman More articles by this author Alex Vanni More articles by this author Expand All Advertisement PDF downloadLoading ...