Are buccal mucosal grafts useful for continent catheterizable channel stenosis? A French' reconstructive urology centers experience.

INTRODUCTION

Cutaneous stoma stenosis represents a frequent complication associated with continent catheterizable channel, often necessitating recurrent patients' consultation, hospital admission, and repetitive surgical interventions. Management strategies encompass dilatation, incision, and, in case of refractory stenosis, invasive surgical revision.

OBJECTIVES

In this study, we aimed to assess the efficacy of buccal mucosa graft as an alternative therapeutic approach for managing cutaneous catheterizable channel stenosis.

METHODS

We conducted a retrospective analysis of all patients referred to our two specialized tertiary reconstructive urology centers due to continent catheterizable cutaneous channel stenosis between January 2015 and June 2023. The study cohort comprises patients who had undergone either a Mitrofanoff, an ileal continent catheterizable channel (Monti or Casal) or a Malone antegrade colonic enema procedure (MACE), all of whom exhibited stoma stenosis.

RESULTS

We identified 14 patients who underwent a total of 15 buccal mucosa graft augmentation repairs for stenosis. Following a mean follow-up duration of 30months, 11 out of 15 procedures (73%) demonstrated successful outcomes. Notably, no complication was observed, except in the 4 cases classified as failures. These failures were attributed to either stenosis recurrence (3 cases) or fleshy bud persistence (1 case). Importantly, patients did not report any concerns regarding esthetic or functional complains.

CONCLUSIONS

Buccal mucosa graft emerges as a minimally invasive alternative for repairing continent catheterizable channel stenosis, yielding a promising success rate and an exceptionally low incidence rate of complications.

LEVEL OF EVIDENCE: III.