Extract

Objective

Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs is high and the actual incidence of failed hypospadias is not clear. Urethral stricture is one of these complication in patients underwent repeated failed surgeries. Buccal mucosa seems to be the ideal tissue to reconstruct the urethra.

Methods

8 hypospadias patients who have undergone repeated failed surgeries were enrolled. Their penile skin, urethral plate and dartos fascia were not enough to reconstruct the urethra. We performed urethroplasty using buccal mucosa free grafting. All pts undewent one stage repair. Urethral plate was opened ventrally until healthy urethral mucosa was exposed. Scott retractor and stay sutures were used in order to keep the penis and the urethral plate stretched. The buccal mucosa grafts were taken and then fixed with 5.0 Vicryl suture on the urethral plate. Urethral plate was incised and tubularized on a Ch 18 Foley catheter. At this point penile degloving was performed in order to expose Buck’s fascia and tunica albuginea and correct penile curvature when it was present (6 pts) using Nesbit techique. At this point we redistribuite penile skin in order to improve penis appearence.