Results of buccal mucosal graft urethroplasty in complex hypospadias

ABSTRACT

Urethral reconstruction in complex hypospadias poses a significant challenge. We report our experience using buccal mucosa to repair complex hypospadias. 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. 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. 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