REFINEMENTS IN BUCCAL MUCOSAL GRAFT URETHROPLASTY FOR HYPOSPADIAS REPAIR

We evaluated our experience with buccal mucosa in urethral reconstruct ion for complex hypospadias repair in a total of 62 children operated on at our institution since 1990 at a mean follow-up of 23 months, Aft er the graft had been taken from the lower lip. with possible extensio n to the inner cheek, complete thinning of the graft was performed. Th e graft was then sutured in an onlay fashion to the urethral plate, an d suprapubic urinary diversion was carried out for 3 weeks. Thr overal l complication I-ate in this rather complex series of patients, includ ing 26 ''hypospadias cripples,'' was 13%: the complications involved 3 fistulas. 3 cases of graft necrosis, and only 1 meatal stenosis durin g the follow-up period. These favorable results prompted us to use buc cal mucosa onlays as our cull-ent method of choice for urethral recons truction with avoidance of tubularized repairs. The definite value of this technique, however, will become evident only after a longer follo w-up period and confirmation of these favorable results.