A novel inert collagen matrix for hypospadias repair

Purpose: In select patients with hypospadias in whom genital skin is insuff icient alternative tissues are needed for urethral reconstruction. Although skin and mucosal grafts may be used, they may increase hospitalization and morbidity. We explored the feasibility of using a bladder submucosal, coll agen based inert matrix as a free graft substitute for urethral repair. Materials and Methods: Four patients with a history of hypospadias underwen t repeat hypospadias repair using a collagen based inert matrix for urethra l reconstruction. The inert collagen matrix was trimmed to size as needed f or each patient. The neourethra was created by anastomosing the matrix in a n onlay fashion to the urethral plate with continuous 6-zero polyglactin su tures. The created neourethra size ranged from 5 to 15 cm. Results: After a 22-month followup 3 of the 4 patients had a successful out come in regard to cosmesis and function. One patient in whom a 15 cm. neour ethra was created had a subglanular fistula. Conclusions: The use of a collagen inert matrix appears to be beneficial in patients who have undergone previous hypospadias repair and who may lack s ufficient genital skin for reconstruction.