Shenzhen's First Lingual Mucosal Graft (LMG) Urethroplasty Successfully Performed at South China Hospital of Shenzhen University

Recently, the urology team at South China Hospital of Shenzhen University worked together to remove a portion of lingual mucosa from the patient's tongue and successfully repaired a long-section urethral stricture, which effectively resolved the patient’s sensitive issues. Since LMG urethroplasty is extremely complex and technically demanding, only a few hospitals in China can perform such surgeries. The successful implementation of LMG urethroplasty in Shenzhen is the first of its kind in the country.

Meeting on a Narrow Path": Difficulties in Urination

54-year-old Man Suffers from Dysuria in Silence

Five months ago, 54-year-old Mr. Wang (pseudonym) developed difficulties in urinating after undergoing gallbladder surgery locally and it became increasingly worse. Every trip to the restroom was unbearable, which severely affected his normal life. Mr. Wang sought medical help in many places and underwent several urethral dilations. However, the symptoms of dysuria would always return or even worsen soon after temporary relief. To get further treatment, Mr. Wang exhaustedly asked around and eventually found the urology team at South China Hospital of Shenzhen University. After a series of standardized examinations, he was diagnosed with a long-segment urethral stricture.

The urinary system serves as the "sewer" of the human body, where the urethra is the final pathway for urine to exit the body. Urethral strictures caused by various problems can lead to dysuria, urinary retention, and other symptoms, which may bring pain, infections, and other discomforts to patients, and in severe cases, even lead to renal damage.

"Urethral dilation can generally alleviate the symptoms of urethral stricture but is not a permanent cure," said Prof. Hou Teng, Executive Director of the Urology Department at South China Hospital. Prof. Hou decided to customize a personalized surgical treatment plan for Mr. Wang, helping him get rid of the pain and return to normal life.

Clever Use of Lingual Mucosa to Solve the Problems 

Masterful Execution of “Transplanting” techniques

To treat urethral stricture, traditional urethroplasty can generally be used, which involves completely removing the narrowed section of the urethra and suturing the two ends back together. However, Mr. Wang's urethral stricture was rather long, and the cut ends were far apart after removal, making it hard to perform direct suturing. Thus, the traditional method was not applicable. Prof. Hou went on to say, “We need to cut open the dorsal side of the urethral stricture, and then patch it up to reconstruct a spacious urethra lumen.”

So where could the graft material be found? The answer was surprising that it’s from the tongue! "The lingual mucosa is a concealed and feasible donor site with minimal trauma and no impact on tongue function. It is easy to transplant with strong infection resistance and has a low rate of postoperative restenosis, hence making it widely used in clinical practice. Professor Hou explained. "We recommended the patient undergo LMG urethroplasty after careful discussion."

LMG urethroplasty is a complicated procedure that demands the high technical skills of the surgeon. It is commonly recognized as a highly sophisticated surgery in the field of complex urethral reconstruction. The team for urinary tract reconstruction and repair at South China Hospital of Shenzhen University is made up of doctors from major domestic urinary tract repair centers and has extensive surgical experience and technical knowledge in this field. Therefore, the urology team at South China Hospital was fully confident in performing this surgery.

The Urinary Tract Transforms into Clear "Highway" 

The Patient Returns to a Life of Ease

After fully understanding the treatment options and careful consideration, Mr. Wang decided to give it a try. With the full cooperation of the Anesthesia Surgery Center, the team of the Dept. of Urology at South China Hospital jointly worked to perform LMG urethroplasty.

During the surgery, the urethral stricture was found to be about 4 cm in length, almost the length of a size 7 battery. Through precise and meticulous surgical operations, the surgical team removed a 4.0 cm long and 1.5 cm wide mucosa from the right bottom surface of the tongue and precisely transplanted it to the original long-segment urethral stricture to maximize the width, resulting in a complete and smooth urethra for Mr. Wang. The operation took over 2 hours, and it was the first successful case of LMG urethroplasty carried out in Shenzhen.

"The experts at South China Hospital are excellent! I'm so grateful!", Mr. Wang said. Despite having his tongue operated on, he was able to speak and eat normally the day after the surgery, indicating a good postoperative prognosis. Mr. Wang was pleased at the prospect of soon returning to his normal life.

"In addition to applying the latest clinical treatment techniques, the urology team at South China Hospital develops personalized and precise diagnosis, treatment, and prevention plans for patients throughout their disease process," said Wu Song, Director of the Urology Research Institute at Shenzhen University and head of the urology department. “Guided by medical ethics and regulations, South China Hospital will focus on new productivity and break through clinical challenges by developing innovative clinical treatment techniques and equipment to tackle medical frontiers. At the same time, relying on digital twin technology, we are developing personalized precision medicine to provide patients with more accurate and comprehensive diagnoses and treatment plans."