A novel inert collagen matrix for hypospadias repair.
OBJECTIVE
In select patients with hypospadias in whom genital skin is insufficient 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, collagen based inert matrix as a free graft substitute for urethral repair.


METHODS
Four patients with a history of hypospadias underwent repeat hypospadias repair using a collagen based inert matrix for urethral reconstruction. The inert collagen matrix was trimmed to size as needed for each patient. The neourethra was created by anastomosing the matrix in an onlay fashion to the urethral plate with continuous 6-zero polyglactin sutures. The created neourethra size ranged from 5 to 15 cm.


RESULTS
After a 22-month followup 3 of the 4 patients had a successful outcome in regard to cosmesis and function. One patient in whom a 15 cm. neourethra 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 sufficient genital skin for reconstruction.
Atala
A
A
Department of Urology, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Guzman
L
L
Retik
A B
AB
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003094:Collagen; D005240:Feasibility Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D014521:Urethra / Q000601:surgery*
D003094:Collagen