Buccal mucosal graft for secondary hypospadias repair and urethral replacement

Ahmed, Shahed; Gough, D. C. S.

doi:10.1046/j.1464-410x.1997.00134.x

Cited by 42 publications

(12 citation statements)

References 9 publications

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“…These reports have noted complication rates ranging from 14-57% [16-20], with most complications occurring early (within 6–12 months) after buccal repair [19,20]. Although our early experience with buccal grafts had a complication rate higher than the range previously noted in the literature, our more recent experience is congruent with that of other centers.…”

Section: Discussionsupporting

confidence: 79%

Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study

et al. 2014

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BackgroundThe use of buccal mucosa grafts (BMG) for urethral reconstruction has increased in popularity over the last several decades. Our aim was to describe our institutional experience with and outcomes after BMG urethroplasty.MethodsWe conducted a retrospective cohort study of boys undergoing BMG urethral reconstruction. Preoperative and perioperative characteristics and postoperative outcomes were evaluated.ResultsTwenty-nine patients (median age 8.2 years) underwent BMG urethroplasty from 1995–2012. Of the 10 patients undergoing 1-stage repairs, 6 had tubularized grafts, the last of which was performed in 2000 due to an unacceptably high revision rate (100%). A 2-stage approach was elected for 19 patients (median follow-up 21.3 months). Complications including stricture, fistula, or chordee were seen in 60% of patients completing both stages and 32% required ≥1 revision. However, 71% of 2-stage patients were free of significant problems at last follow-up.ConclusionsWe found BMG to be a reasonable option for use in complex pediatric urethral reconstruction. Tubularized grafts had poor results, and we no longer use them. We favor a 2-stage approach for all patients except those with “simple” non-hypospadiac strictures. Although revision procedures were not uncommon, the majority of patients were ultimately free of long-term problems.

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Section: Discussionsupporting

confidence: 79%

Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study

et al. 2014

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“…Only small defects can be closed primarily without disturbing the function of the parotid duct. With all its side effects secondary healing is the traditional way (Ahmed & Gough 1997). Discomfort in the early post‐operative period has been described, too, when the explantation site had been covered by Lyodura, Syspurderm or Ethisorp (Szulczewski et al 1999).…”

Section: Discussionmentioning

confidence: 99%

Clinical application of tissue‐engineered transplants. Part I: mucosa

Sauerbier

Gutwald

Wiedmann-Al-Ahmad

et al. 2006

Clinical Oral Implants Res

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Section: Discussionmentioning

confidence: 99%

“…Compromised tissue vascularity and insufficient penile and preputial skin create a difficult setting in which to reconstruct a viable, patent neourethra. Numerous tissues and techniques have been described for repairing hypospadias complications, including buccal mucosa [8] split-thickness skin graft [9], and tunica vaginalis [10,11]. Urethrocutaneous fistulae and proximal urethral and meatal strictures comprise the most common complications of primary hypospadias repair that require reoperation [2,12].…”

Section: Discussionmentioning

confidence: 99%

Re‐operative hypospadias repair using the Snodgrass incised plate urethroplasty

2001

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Objective To retrospectively assess the results of tubularized incised plate (Snodgrass) urethroplasty in a series of re-operative hypospadias repairs in children. Patients and methods The study comprised a follow-up (from 1996 until 2000) of 13 patients (mean age 7.5 years, range 13 months to 27 years) who had at least one previous hypospadias repair and who then underwent a reconstruction using the Snodgrass repair. In all cases the urethroplasty was covered with an additional layer of subcutaneous tissue. The original location, associated complications and results were recorded. In some cases, the long-term follow up was conducted by telephone. Results Associated complications before the Snodgrass repair included urethral stricture in two, fistula in three and persistent chordee in one patient. The mean (range) follow-up was 22 (9-34) months. The cosmetic results were excellent, with two complications (one patient with a glans dehiscence and a urethrocutaneous fistula, and a second with meatal stenosis). The remaining patients required no further procedures and were voiding normally at the last follow-up. Conclusion Excellent cosmetic and functional results can be obtained using the Snodgrass incised plate urethroplasty for re-operative hypospadias repair. Only one patient in this series had an initial operation in which the urethral plate was previously incised. Therefore, caution should be used when considering an incised plate urethroplasty in these patients.

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Buccal mucosal graft for secondary hypospadias repair and urethral replacement

Cited by 42 publications

References 9 publications

Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study

Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study

Clinical application of tissue‐engineered transplants. Part I: mucosa

Re‐operative hypospadias repair using the Snodgrass incised plate urethroplasty

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