{"id":667,"date":"2017-12-06T13:00:22","date_gmt":"2017-12-06T13:00:22","guid":{"rendered":"http:\/\/cru.aeu.es\/?p=667"},"modified":"2017-12-06T13:00:22","modified_gmt":"2017-12-06T13:00:22","slug":"cerramos-o-no-la-boca","status":"publish","type":"post","link":"https:\/\/cru.aeu.es\/?p=667","title":{"rendered":"Cerramos o no la boca?"},"content":{"rendered":"
Eur Urol.<\/a><\/span>\u00a02017 Nov 30. pii: S0302-2838(17)30999-5. doi: 10.1016\/j.eururo.2017.11.014. [Epub ahead of print]<\/div>\n

Substitution<\/span>\u00a0Urethroplasty<\/span>\u00a0with\u00a0Closure<\/span>\u00a0Versus<\/span>\u00a0Nonclosure<\/span>\u00a0of the\u00a0Buccal<\/span>\u00a0Mucosa<\/span>\u00a0Graft<\/span>\u00a0Harvest<\/span>Site<\/span>: A\u00a0Randomized<\/span>\u00a0Controlled<\/span>\u00a0Trial<\/span>\u00a0with a\u00a0Detailed<\/span>\u00a0Analysis<\/span>\u00a0of\u00a0Oral<\/span>\u00a0Pain<\/span>\u00a0and\u00a0Morbidity<\/span>.<\/h3>\n
Soave A<\/a>1<\/sup>,\u00a0Dahlem R<\/a>2<\/sup>,\u00a0Pinnschmidt HO<\/a>3<\/sup>,\u00a0Rink M<\/a>2<\/sup>,\u00a0Langetepe J<\/a>2<\/sup>,\u00a0Engel O<\/a>2<\/sup>,\u00a0Kluth LA<\/a>2<\/sup>,\u00a0Loechelt B<\/a>2<\/sup>,\u00a0Reiss P<\/a>2<\/sup>,\u00a0Ahyai SA<\/a>4<\/sup>,\u00a0Fisch M<\/a>2<\/sup><\/div>\n
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<\/div>\n<\/div>\n
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BACKGROUND:<\/h4>\n

Optimal surgical management of the\u00a0buccal<\/span>\u00a0mucosa<\/span>\u00a0harvest<\/span>\u00a0site<\/span>\u00a0in patients with urethral stricture disease during\u00a0buccal<\/span>mucosa<\/span>\u00a0graft<\/span>\u00a0urethroplasty<\/span>\u00a0(BMGU) remains controversial.<\/p>\n

OBJECTIVE:<\/h4>\n

To analyze in detail intensity and quality of\u00a0pain<\/span>\u00a0as well as\u00a0oral<\/span>\u00a0morbidity<\/span>\u00a0following\u00a0closure<\/span>\u00a0(C)\u00a0versus<\/span>\u00a0nonclosure<\/span>\u00a0(NC) of the donor\u00a0site<\/span>.<\/p>\n

DESIGN, SETTING, AND PARTICIPANTS:<\/h4>\n

Randomized<\/span>\u00a0controlled<\/span>\u00a0trial<\/span>\u00a0on 135 patients treated with BMGU between October 15, 2014 and December 18, 2015.<\/p>\n

INTERVENTION:<\/h4>\n

Following computer-based randomization, 63 and 72 patients, respectively, received C and NC of the donor\u00a0site<\/span>\u00a0at the inner cheek. Preoperatively, on days 1, 5, and 21 as well as at 3 and 6 mo postoperatively, patients completed standardized questionnaires, including validated questions on intensity and quality of\u00a0pain<\/span>\u00a0as well as\u00a0oral<\/span>\u00a0morbidity<\/span>.<\/p>\n

OUTCOME MEASUREMENTS AND STATISTICAL\u00a0ANALYSIS<\/span>:<\/h4>\n

The coprimary end points were intensity and quality of\u00a0oral<\/span>\u00a0pain<\/span>. Secondary end points included\u00a0oral<\/span>\u00a0morbidity<\/span>\u00a0and intensity of\u00a0pain<\/span>\u00a0of the perineogenital region. Generalized linear mixed models evaluated the effect of various covariates on intensity and quality of\u00a0oral<\/span>\u00a0pain<\/span>,\u00a0oral<\/span>\u00a0morbidity<\/span>, as well as intensity of\u00a0pain<\/span>\u00a0of the perineogenital region.<\/p>\n

RESULTS AND LIMITATIONS:<\/h4>\n

There was noninferiority for NC\u00a0versus<\/span>\u00a0C in intensity and affective quality of\u00a0oral<\/span>\u00a0pain<\/span>\u00a0at every time point following BMGU.\u00a0Oral<\/span>\u00a0morbidity<\/span>\u00a0and complications included\u00a0pain<\/span>, bleeding, swelling, numbness, alteration of salivation and taste, as well as impairment of mouth opening, smiling, whistling, diet, and speech. Time from BMGU had significant effects on intensity (p<0.001) and quality of\u00a0oral<\/span>\u00a0pain<\/span>\u00a0(sensory\u00a0pain<\/span>: p<0.001, affective\u00a0pain<\/span>: p<0.001, total\u00a0pain<\/span>: p<0.001). Length of\u00a0buccal<\/span>\u00a0mucosa<\/span>\u00a0graft<\/span>\u00a0had significant effects on intensity (p=0.001) and quality of\u00a0oral<\/span>\u00a0pain<\/span>\u00a0(sensory\u00a0pain<\/span>: p=0.020, total\u00a0pain<\/span>: p=0.042).<\/p>\n

CONCLUSIONS:<\/h4>\n

NC is noninferior to C of the donor\u00a0site<\/span>\u00a0in intensity and quality of\u00a0oral<\/span>\u00a0pain<\/span>, and offers a treatment alternative. Time from BMGU and length of the\u00a0buccal<\/span>\u00a0mucosa<\/span>\u00a0graft<\/span>\u00a0have effects on\u00a0oral<\/span>\u00a0morbidity<\/span>\u00a0and complications.<\/p>\n

PATIENT SUMMARY:<\/h4>\n

We investigated\u00a0pain<\/span>,\u00a0morbidity<\/span>, and complications following\u00a0closure<\/span>\u00a0(C)\u00a0versus<\/span>\u00a0nonclosure<\/span>\u00a0(NC) of the\u00a0buccal<\/span>\u00a0mucosa<\/span>harvest<\/span>\u00a0site<\/span>\u00a0in patients undergoing\u00a0buccal<\/span>\u00a0mucosa<\/span>\u00a0graft<\/span>\u00a0urethroplasty<\/span>\u00a0(BMGU). We found that NC is not worse than C regarding\u00a0oral<\/span>\u00a0pain<\/span>. In addition, time from BMGU and length of the\u00a0buccal<\/span>\u00a0mucosa<\/span>\u00a0graft<\/span>\u00a0have effects on\u00a0oral<\/span>\u00a0morbidity<\/span>\u00a0and complications.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Eur Urol.\u00a02017 Nov 30. pii: S0302-2838(17)30999-5. doi: 10.1016\/j.eururo.2017.11.014. [Epub ahead of print] Substitution\u00a0Urethroplasty\u00a0with\u00a0Closure\u00a0Versus\u00a0Nonclosure\u00a0of the\u00a0Buccal\u00a0Mucosa\u00a0Graft\u00a0HarvestSite: A\u00a0Randomized\u00a0Controlled\u00a0Trial\u00a0with a\u00a0Detailed\u00a0Analysis\u00a0of\u00a0Oral\u00a0Pain\u00a0and\u00a0Morbidity. Soave A1,\u00a0Dahlem R2,\u00a0Pinnschmidt HO3,\u00a0Rink M2,\u00a0Langetepe J2,\u00a0Engel O2,\u00a0Kluth LA2,\u00a0Loechelt B2,\u00a0Reiss P2,\u00a0Ahyai SA4,\u00a0Fisch M2 BACKGROUND: Optimal surgical management of the\u00a0buccal\u00a0mucosa\u00a0harvest\u00a0site\u00a0in patients with urethral stricture disease during\u00a0buccalmucosa\u00a0graft\u00a0urethroplasty\u00a0(BMGU) …<\/p>\n

Cerramos o no la boca?<\/span> Leer m\u00e1s \u00bb<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-667","post","type-post","status-publish","format-standard","hentry","category-adulto-uretra"],"_links":{"self":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts\/667","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=667"}],"version-history":[{"count":1,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts\/667\/revisions"}],"predecessor-version":[{"id":668,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts\/667\/revisions\/668"}],"wp:attachment":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=667"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=667"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=667"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}