title: Split-thickness skin graft urethroplasty and tunica vaginalis flaps for failed hypospadias repairs.
abstract: OBJECTIVE
  Via a 2-stage procedure, 10 patients with failed hypospadias repairs were treated by a varied combination of split-thickness mesh graft urethroplasty and tunica vaginalis flap.
  
  
  METHODS
  A bed for the mesh graft in 3 patients was provided by a tunica vaginalis flap. Tunica vaginalis flaps were also used as an intermediate layer during stage 2 of the repair.
  
  
  RESULTS
  No strictures or fistulas occurred in 8 patients. Two patients await stage 2 repair after successful stage 1 placement of the mesh graft.
  
  
  CONCLUSIONS
  The combination of split-thickness mesh graft urethroplasty and a tunica vaginalis flap appears to achieve success in the difficult patient with complex hypospadias subsequent to multiple failed repairs.
mesh_terms: D000328:Adult; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D010413:Penis / Q000601:surgery; D012086:Reoperation; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000379:methods*; D017211:Treatment Failure; D014521:Urethra / Q000601:surgery*