Page 82 - Read Online

Page 10 of 11 El-Ghoneimi et al. Plast Aesthet Res 2022;9:39 https://dx.doi.org/10.20517/2347-9264.2021.101

It is worth mentioning that the use of bladder mucosal graft might develop specific complications related to
the nature of bladder mucosa, especially if there is an additional factor such as urine stagnation in the
reconstructed urethra. Weingärtner et al. reported nephrogenic adenoma in six cases of reconstructed
[20]
urethra using bladder mucosa graft .

Our study has multiple limitations. The cohort of patients is heterogenous and of small number. The
complications rates may vary according to the specific indications and duration of follow-up. In fact, if we
consider one year as a minimum follow-up period to conclude success, we should exclude Case 8 from the
study, which brings the valid cohort to nine patients. Consequently, the success rate would be 44% and not
50%. To give all the details of our cohort, we report clearly in Table 1 all the follow-up periods and the
complications of treatment. This leaves the surgeon to evaluate the eventual benefit of using our technique
in their specific patient. We certainly acknowledge that these complex cases need to be reported with as long
a follow-up as possible, not only one year but also long-term follow-up as complications may appear even
after 10 years (after puberty and sexual activities).

Despite the heterogenicity of our cohort, our indication was mainly the same: a paucity of healthy skin
coverage and the urethral defect being significantly long compared to previously published series.

In conclusion, the tunneled bladder mucosa tube graft technique represents a good alternative for a long
urethroplasty in patients with a paucity of healthy skin. The minimal detrusotomy technique for graft
retrieval may reduce graft harvesting morbidity.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: El-Ghoneimi A, Peycelon M
Performed data acquisition, and material support: Lachkar AA, Lopez P, Paye-Jaouen A

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
The research was performed in accordance with the Declaration of Helsinki.

Consent for publication
A written informed consent for photography and publication was obtained.

Copyright
© The Author(s) 2022.