Ten years' experience for hypospadias repair: combined buccal mucosa graft and local flap for urethral reconstruction.

OBJECTIVES

To share our experience in hypospadias repair and discuss the clinical implications of our method, which consists of a combined buccal mucosa graft and local flap for urethroplasty.

PATIENTS AND

METHODS

1,394 cases (median age 11.3 years, age range 5 months to 53 years) of hypospadias which were repaired using our method between July 2000 and December 2010 in our department were included in this study. The patients who had a short penis or did not have chordee were excluded from the data. 588 cases (42.2%) had previously undergone surgery in other hospitals but failed; 806 (57.8%) cases had undergone the first treatment in our department.

RESULTS

Of the 806 cases which had undergone the first treatment in our department, we successfully reconstructed the urethra for 747 patients (92.3%), and 59 patients had complications (7.7%); of the 588 cases which had previously undergone surgery but failed, we successfully reconstructed the urethra for 522 patients (88.8%), and 66 patients had complications (11.2%). The most common complication was urethra fistula (70; 5%); other complications include necrosis of the skin flap and infection resulting in wound disruption (19; 1.4%), urethral diverticula (11; 0.8%) and urethral stricture (25; 1.8%).

CONCLUSIONS

Our method appears to be a safe, simple and satisfactory surgical procedure and can provide relatively enough tissue to reconstruct the urethra with a higher success rate.