Results of Use of Tissue-Engineered Autologous Oral Mucosa Graft for Urethral Reconstruction: A Multicenter, Prospective, Observational Trial

EBioMedicine. 2017 Sep:23:185-192. doi: 10.1016/j.ebiom.2017.08.014. Epub 2017 Aug 16.

Abstract

Background: Harvest of oral mucosa for urethroplasty due to urethral stricture is associated with donor-site-morbidity. We assessed functionality and safety of an authorized tissue-engineered oral mucosa graft (TEOMG) under routine practice in stricture recurrences of any etiology, location, length and severity (real-world data).

Methods: 99 patients from eight centers with heterogenous urethroplasty experience levels were included in this prospective, non-interventional observational study. Primary and secondary outcomes were success rate (SR) and safety at 12 and 24months.

Findings: All but one patient had ≥1, 77.1% (64 of 83)≥2 and 31.3% (26 of 83)≥4 previous surgical treatments. Pre- and postoperative mean±SD peak flow rate (Qmax) were 8.3±4.7mL/s (n=57) and 25.4±14.7mL/s (n=51). SR was 67.3% (95% CI 57.6-77.0) at 12 and 58.2% (95% CI 47.7-68.7) at 24months (conservative Kaplan Meier assessment). SR ranged between 85.7% and 0% in case of high and low surgical experience. Simple proportions of 12-month and 24-month SR for evaluable patients in all centers were 70.8% (46 of 65) and 76.9% (30 of 39). Except for one patient, no oral adverse event was reported.

Interpretations: TEOMG is safe and efficient in urethroplasty.

Keywords: ATMP; Graft; Oral mucosa; Reconstruction; Tissue engineering; Urethra stricture.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mouth Mucosa / transplantation*
  • Plastic Surgery Procedures* / adverse effects
  • Plastic Surgery Procedures* / methods
  • Postoperative Complications
  • Proportional Hazards Models
  • Recurrence
  • Risk Factors
  • Tissue Engineering*
  • Transplantation, Autologous
  • Treatment Outcome
  • Urethral Stricture / pathology*
  • Urethral Stricture / surgery*
  • Young Adult