The Multistage Use of Buccal Mucosa Grafts for Complex Hypospadias: Histological Changes

Abstract

Multistage repair using buccal mucosa is an excellent option for urethral reconstruction. It guarantees excellent graft uptake and good vasculature, which improves success. It also provides supple tissue for glanular and urethral reconstruction in cases of severe complex hypospadias.

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

“…BMG is an attractive option due to the fact that it is a mucosal, non-hair bearing surface with fast uptake and vascularization after free grafting for urethral substitution [10,11]. BM tissue is abundant and accessible and the donor site morbidity is acceptably low [12,13], although contractures have been reported with lip donor sites [14], as well as with large cheek grafts [15].…”

Two-Stage Urethroplasty for Severe Primary Hypospadias

“…In general, oral mucosa is the first choice, followed by postauricular skin when oral pathology exists. It is proposed that use of free graft from extragenital origin results in good cosmesis and diminished complication rate (Markiewicz et al, 2007;Mokhless et al, 2007;Tahmeedullah et al, 2003). Some authors propose that all other extra-genital skin graft sites such as groin or inner arm should be avoided altogether.…”

“…The grafts were harvested from extragenital skin, inner prepuce, and evolved to oral mucosa. The latter becomes a new gold standard as urethra substitute in two-stage repair advocated by some authors today (Goyal et al, 2010;Markiewicz et al, 2007;Mokhless et al, 2007;Simonato et al, 2008). Notwithstanding the dispute on single-stage vs two-stage repairs is ardent, agreement exists that procedure assignment in hypospadias repair is highly based on the patient's individual anomaly status and on the surgeon's individual experience and preference.…”

Retalhos tubulares de pele de ratos com dois tipos de cateter de silicone

“…Este procedimento tem sido usado para a correção cirúrgica de várias afecções urológicas, em especial para o tratamento da hipospádia, defeito congênito onde o meato uretral se localiza na face ventral do pênis e que, no Brasil, incide em 1:565 recém-nascidos vivos do sexo masculino 1,2,3 . Em relação à correção das hipospádias, existem controvérsias quanto aos riscos e benefícios do uso de sondas para moldar a nova uretra e promover a derivação urinária após a cirurgia 1,4 .…”