The bladder mucosal graft technique for hypospadias repair.

A technique for the repair of severe hypospadias is described. The essential features include: chordee release and cosmetic repair of the previously tethered penis; the construction of a new urethra using bladder mucosa in a subcutaneous tunnel; and an oblique anastomosis of the graft and true urethra as deep within the shaft of the penis as possible. One stricture has developed utilizing this technique. The remainder of the children appear to have obtained a good result. Meatal stenosis requiring dilatation remains a minor problem. The use of bladder mucosal grafts in cases in which previous repairs have failed or when adequate foreskin for urethral reconstruction is lacking is feasible and has been successfully performed in adults. The combination of a chordee release and bladder mucosal inlay graft as a single-stage procedure in a small child had not yet been attempted.