Clinical study of transurethral oral mucosa graft in the repair of external urethral orifice stricture

ZHU Ji; ZHANG Zhewei; WU Huifeng

doi:10.13263/j.cnki.nja.2026.02.005

Abstract：Objective To evaluate the safety and efficacy of transurethral oral mucosa graft in repairing external urethral orifice stricture.Methods The clinical data of 6 patients with external urethral stricture who underwent transurethral oral mu-cosa graft urethroplasty in the Department of Urology of the Second Affiliated Hospital of Zhejiang University from December 2023 to July 2024 were analyzed retrospectively.The age ranged from 17 to 69 years old,with an average of 57.3 years old.The course of the disease ranged from 6 months to 7 years,with an average of 3.1 years.Two cases had a history of benign prostatic hyperplasia,1 case had a history of indwelling catheterization,1 case had a history of recurrent glans urethritis caused by phimo-sis,1 case had a history of sclerosing lichen sclerosus of penis(lichen sclerosus,LS),and 1 case had no obvious inducement.The length of urethral stricture ranged from 0.5 to 2.0 cm,with an average of 1.1 cm.In 4 patients.The external orifice of ure-thra was cut longitudinally at 4 and 8 o'clock,and the narrow scar tissue was cut off by ophthalmology to form a fan-shaped wound,and the tongue mucosa of corresponding size was taken according to the size of the fan-shaped wound.One end of the double-headed 6-0PDS suture passed through the normal urethral mucosa of the fan-shaped apex of the oral mucosa and the apex of the urethral fan-shaped wound,then through the ventral skin of the penis,and the other end of the suture passed through the apex of the fan-shaped wound of the urinary tract from the abdominal skin of the penis.Tighten the knot suture outside the ventral skin of the penis.The margin of oral mucosa and urethral wound were sutured intermittently.In 2 cases,the tongue mucosa was replaced by the mucous membrane of the dorsal urethra.Results All the 6 patients completed the operation successfully.After the catheter was removed 2 weeks after operation,all the patiens had unobstructed urination,and there was no evidence of ische-mic necrosis in the transplanted tongue mucosa.All patients were satisfied with the appearance of the penile head.Postoperative follow-up ranged from 5 months to 11 months,with an average of 8.3 months.Half a year after operation,the maximum urinary flow rate was 11.2 mL/s urinary 22.0 mL/s,with an average of 15.9 mL/s.In one patient,the urine line became thinner 4 months after operation,and the adhesion of the external orifice of the urethra was found after revisit.The symptoms disappeared after urethral dilatation,and there were no obvious complications in the other patients.Conclusion Transurethral oral mucous membrane graft is an ideal surgical method for repairing external urethral orifice stricture.This operation not only has accurate effect and low recurrence rate of stenosis,but also takes into account the beauty of the head of the penis.