The utility of buccal mucosa graft in salvage urethroplasty.

OBJECTIVE

To evaluate our results with buccal mucosa free grafts in salvage urethroplasty.

PATIENTS AND

METHODS

Retrospective chart review of autologous buccal mucosa grafts for urethral reconstruction at Winnipeg Children's Hospital and Children's Hospital of Eastern Ontario between November 1992 and March 2000.

RESULTS

Nine patients (median age 4 years) underwent such reconstruction. Seven of the nine patients had experienced failed previous attempts at hypospadias repair. Onlay grafts were used in all but one patient who required a tube graft. Urethrocutaneous fistula was the most common post-operative complication, affecting four of nine patients. Two patients developed urethral strictures and one a meatal stenosis. Satisfactory functional results were ultimately achieved in all patients. Harvest site complications were minimal.

CONCLUSIONS

Buccal mucosa is a readily available and useful source for urethral grafting material, but should only be used in patients with insufficient penile skin. Grafts may be used as onlays or tubes. It is our experience that despite precautionary measures, fistulae and strictures are common.