Introduction. Hypospadias represents the most frequent penile anomaly. The
most challenging part of hypospadias surgery is urethral reconstruction. Many
various tissues are used (local skin flaps, bladder mucosa grafts, buccal
mucosa grafts etc.) for the reconstruction of the neourethra. Objective. Our
aim was to evaluate advantages and disadvantages of combined buccal mucosa
graft and penile skin flap in urethral reconstruction in severe hypospadias
repair. Methods. Between December 2005 and August 2009, 48 patients with
severe hypospadias, aged from nine months to 12 years (mean age 23 months)
underwent surgery. Thirty-four (71%) had penoscrotal and 14 (29%) scrotal
hypospadias. Ventral penile curvature was present in all cases, and was
corrected by incision of the short urethral plate. Urethroplasty was
performed using a buccal mucosa graft combined with dorsal penile skin flap.
Results. Mean follow-up was 22 months (range from 9 months to 3 years).
Satisfactory functional and aesthetic results were achieved in 40 (83%)
patients. Fistula was noted in six cases and was solved by minor revision.
Urethral stenosis in two cases was resolved by simple dilatation. Conclusion.
Urethral reconstruction using the buccal mucosa graft and dorsal penile skin
flap in severe hypospadias repair could be the method of choice. Using this
technique, single stage urethral reconstruction is possible with satisfactory
esthetical and functional results.
Urethral reconstruction in severe hypospadias using buccal mucosa graft and penile skin flap
