Use of bladder mucosal graft for urethral reconstruction

Background: The ideal tissue for complex urethral reconstruction has yet to be determined, especially in patients with deficient preputium. The use of bladder mucosa as a free graft could be an alternative in these problem ca ses. Methods: Bladder mucosa graft urethroplasty was performed on 14 patients wi th penoscrotal or scrotal hypospadias. The mean age of the patients was 18. 7 (range 14-23) years. Ten cases were subjected to primary urethral reconst ruction while four cases had previous hypospadias repair. Results: Complete urethral replacement by the bladder mucosa tube was perfo rmed in six patients. Meatal problems occurred in two (33.33%) patients and proximal fistula formed in one (16.67%) patient. A bladder mucosa graft wa s combined with preputial or tunica vaginalis grafts distally in eight case s, and one patient in the tunica vaginalis group developed fistula at the a nastomosis of the bladder mucosa and tunica vaginalis grafts. The overall c omplication rate was 28.6%. Conclusions: Our initial results showed that bladder mucosa grafts can be u sed successfully for urethral reconstruction especially when combined with preputial or tunica vaginalis grafts distally.