Introduction and Objectives
Urethral stricture is one of the common complications after severe hypospadias repair. Usually, two or more procedures are needed to its correction due to a lack of available material after previous repair. We present one stage urethral reconstruction by ventral placement of buccal mucosa graft and emphasize necessity for its hanging to periurethral tissue.
Material and Methods
In period from August 2002 to September 2008, 13 patients, aged 9 to 32 years, underwent urethral stricture repair after failed hypospadias surgery. Stricture was opened ventrally and properly sized buccal mucosa graft was placed to augment urethral lumen. Graft was hanged on surrounding urethral tissue by several U sutures. This way, good covering of the graft and prevention of its folding with retraction were achieved. Associate chordee (10 patients) and secondary vesicoureteral reflux (3) were corrected simultaneously.
Mean follow-up was 36 (8–71) months. A successful result was confirmed in all patients by urethrography and uroflowmetry. One urethral fistula was corrected three months later. Recurvation did not occur in this group. There was no recurrence of the reflux in endoscopically treated patients.
Hanged ventral buccal mucosa graft presents simple and safe variant for urethral stricture repair. Proper anchoring of the graft is very important for its survival and prevention of folding with retraction.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.