Follow-up and histocompatibility observation of urethral reconstruction with different materials.

ABSTRACT

OBJECTIVE: Our objective is to observe the long-term surgical results of urethral reconstruction using either pedicled penile flaps or lingual mucosa grafts. We also assess the histocompatibility of the reconstructed urethra. MATERIALS AND METHODS: Clinical data of patients with anterior urethral stenosis undergoing urethra reconstruction by applying different materials were collected from 2014 to 2022 in the Second Hospital of Hebei Medical University. We assessed their efficacy and the occurrence of complications. Patients who required reoperation due to complications were selected. Sections of the reconstructed urethra created with various materials were excised during repair procedures. The excised tissues underwent hematoxylin-eosin staining and immunohistochemistry. Comparison with the original histological morphology was conducted to evaluate histocompatibility. RESULTS: 42 of the 55 patients were cured which showed a surgical success rate of 76.36%. The success rate of urethra reconstruction surgery utilizing lingual mucosa is 71.43% and that of surgeries using pedicled penis flaps is 79.41%. The long-term prognosis of the two groups is similar (P > 0.05). Observations show that the histological morphology of the original epithelium gradually disappeared, leading to adaptive changes to the urinary environment with favorable histocompatibility. CONCLUSION: The application of lingual mucosal and pedicled penis flaps for urethral reconstruction both have a high surgical success rate. The long-term follow-up results are positive. Both methods are viable for urethral reconstruction and exhibit favorable histocompatibility.