The use of small intestinal submucosa graft for XXXX repair: Pilot study.

@entity1 @entity2650
OBJECTIVE: To evaluate the outcome of using commercially available (SIS) grafts for repairing @entity2650 . Collagen-based acellular matrices, including SIS and bladder submucosa matrix, have been used to repair urethral strictures, with varying success, and @entity1 with @entity2650 and with inadequate or no genital skin need a substitute tissue for urethroplasty. @entity1 AND METHODS: This pilot study included 12 @entity1 (mean age 8  years, range 1.5-15) with @entity2650 (distal in six, mid-shaft in four and proximal in two). They underwent a repair with four layers of prefabricated SIS as an onlay graft. The outcome was assessed for cosmetic appearance, urinary stream and the postvoid residual volume. The chi-squared and Mann-Whitney U-tests were used to assess the relationship between preoperative factors and the outcome of the repair with SIS grafting. RESULTS: The mean (range) follow-up was 23 (6-36) months. Nine @entity1 ultimately voided normally, with a good cosmetic appearance and no postvoid residual urine. Six @entity1 had a successful repair with no further intervention, whilst three had small fistulae that were treated by simple closure. In three @entity1 the graft failed, by complete disruption or stricture. Graft infection adversely affected the outcome of SIS grafting. CONCLUSIONS: The prefabricated SIS graft can be used as an alternative substitute for urethral reconstruction when genital skin is insufficient or lacking, as in circumcised @entity1 or a @entity2650 repair. Graft infection is the chief reason for graft failure and should be prevented. Further studies with more @entity1 are needed to confirm these preliminary results.
