Single stage repair with buccal mucosal graft in hypospadias cripple patients

Mohit Jain, Shivam Madeshiya, Neeraj Sharma


Background: Hypospadias surgery has developed into a well-defined art and science. Surgeons dealing with this anomaly should have detailed understanding of various basic surgical principles and experience with delicate, precise optically assisted techniques and maintain a clinical workload that is sufficient to obtain consistently good results. Objective of this study was to evaluate the outcome of using buccal mucosal graft for single stage repair in adult hypospadias cripples.

Methods: All patients with prior failed hypospadias repair after multiple surgeries presenting in MLN Medical College, Allahabad were included in study. Dorsal onlay buccal mucosa graft with parallel turn over flap from penile skin for ventral surface method was used.

Results: Total 20 patients were included in study. Among these 12 patients presented with complete dehiscence of repair, 5 patients presented with multiple urethrocutaneous fistulas, 3 patients presented with extensive stricture formation. Same surgeon performed procedure of dorsal onlay buccal mucosa graft urethroplasty to reduce the bias. Success rate of dorsal onlay substitution free buccal mucosal graft urethroplasty in single stage is affected by scarring of surrounding penile skin. Most common complication related to donor site are transient pain and swelling and to graft site are stricture and fistulas.

Conclusions: Single stage repair with buccal mucosal graft in hypospadias cripple patients is an excellent free graft urethroplasty in cases with prior failed primary repair of hypospadias, in whom the preputial skin was lacking or insufficient and a longer urethral tube needed to be constructed.


Dorsal onlay buccal mucosa graft urethroplasty, Hypospadias cripples, Scarring

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