INTRODUCTION: Urethral reconstruction in complex hypospadias poses a significant challenge. We report our experience using buccal mucosa to repair complex hypospadias. MATERIALS AND METHODS: From February 2001 to September 2003, 16 urethral reconstructions were performed using buccal mucosal graft. Twelve of the patients had previously failed urethroplasties, while the other 4 had perineal or scrotal hypospadias. Grafts were harvested from the lower lip. Onlay grafts were used in 8 cases, and tubularized grafts were used for the others. RESULTS: After 14 to 27 months' follow-up, 11 of 16 (69%) patients developed complications, including meatal stenosis in 2 (12.5%), urethral stricture in 5 (31%), and urethrocutaneous fistula in 4 (25%). No oral complications were seen, and all of the urethroplasty complications were managed successfully. CONCLUSION: Urethroplasty using a buccal mucosal graft may be accompanied by a relatively high complication rate, which is more common in patients with tubularized graft; however, all complications can be managed successfully. We believe that urethroplasty using buccal mucosal graft in complex hypospadias is an acceptable treatment modality.
INTRODUCTION: Urethral reconstruction in complex hypospadias poses a significant challenge. We report our experience using buccal mucosa to repair complex hypospadias. MATERIALS AND METHODS: From February 2001 to September 2003, 16 urethral reconstructions were performed using buccal mucosal graft. Twelve of the patients had previously failed urethroplasties, while the other 4 had perineal or scrotal hypospadias. Grafts were harvested from the lower lip. Onlay grafts were used in 8 cases, and tubularized grafts were used for the others. RESULTS: After 14 to 27 months' follow-up, 11 of 16 (69%) patients developed complications, including meatal stenosis in 2 (12.5%), urethral stricture in 5 (31%), and urethrocutaneous fistula in 4 (25%). No oral complications were seen, and all of the urethroplasty complications were managed successfully. CONCLUSION: Urethroplasty using a buccal mucosal graft may be accompanied by a relatively high complication rate, which is more common in patients with tubularized graft; however, all complications can be managed successfully. We believe that urethroplasty using buccal mucosal graft in complex hypospadias is an acceptable treatment modality.
Authors: Abhay Kumar; Suren K Das; Girish K Sharma; Ashwani K Pandey; Sameer Trivedi; Udai S Dwivedi; Pratap B Singh Journal: World J Urol Date: 2008-04-19 Impact factor: 4.226