Presentation Authors: Jaisukh Kalathia*, Indore, India, Kaushal Patel, Venkatesh Krishnamoorthy, anantapur, India
Introduction: Buccal mucosal graft (BMG) is frequently used for reconstruction of urethral strictures with acceptable donor site morbidity after the graft harvest. There are only few prospectively designed studies with small number of patients reporting the oral complications particularly the mouth opening in the long term. We did the objective assessment of the mouth opening before and after 6 months of BMG urethroplasty as well as the pain scores.
Methods: A total of 58 patients who underwent BMG urethroplasty were included in the study between May 2013 to December 2014. Pre-operative mouth opening (reference point between two incisors with highest of three readings taken as final) was measured using Vernier calipers. The harvest site was left open to heal by secondary intentions. Post-operatively, the mouth opening and pain scores using self-administered [Visual Analogue Scale (VAS)] were assessed on Day 1, Day 3 and in follow-up at 1 week, 1 month and at 6 months. Data was analyzed as mean (Standard Deviation), proportion and median (Inter Quartile Range) with two tailed p value < 0.05 as significant.
Results: Mean age was 39.6 years. The graft was harvested from a single cheek in 50% of patients. In remaining patients, graft was taken from both cheeks, both cheeks with lip and both cheeks with tongue in 29.31%, 17.24% and 3.5% respectively. Pre-operative mouth opening [5.13 cm (0.08] was significantly more than the mouth opening at Day 1 [4.34 cm (0.09)], Day 3 [4.48 (0.09)] and Day 7 [4.69 cm (0.09)]. However, the mean difference became insignificant at the interval of 1 month [4.91 cm (0.09)] with 6 month's values showing marginal improvement over preoperative values [5.14 cm (0.07)]. Pain was tolerable and the patients reported low median VAS 2 [2-4] on Day 1 and Day 3 each. The Reported median VAS became 0 [0- 0] by day 7.
Conclusions: Mouth opening restriction after BMG urethroplasty is a definite entity in the initial post-operative period which becomes non significant by the end of 6 months. The pain by itself has no effect on mouth opening