title: Combined buccal mucosa graft and local flap for urethral reconstruction in various forms of hyposapdias.
abstract: OBJECTIVE
  Hypospadias is one of the most common congenital deformities in the male urogenital system. Although there are more than 250 techniques for treating hypospadias, it is often difficult to repair severe hypospadias using conventional methods.
  
  
  METHODS
  We combined a buccal mucosa graft with a local onlay flap for urethral reconstruction in cases of severe hypospadias or a failed previous operation. A total of 162 patients with hypospadias (glandular 11, penile 40, penoscrotal 49, scrotal 34 and perineal 28) were treated between July 2000 and November 2003. For patients whose urethral meatus was perineal 2 treatment steps were taken. First, we used the aforementioned method to construct the penile urethra, and then we constructed the scrotal and perineal urethra with a local flap.
  
  
  RESULTS
  Of the 134 nonperineal cases 127 were managed successfully in 1 stage, and 26 of 28 perineal cases were managed successfully in 2 stages. Most patients had a satisfactory penile appearance. A urethral fistula resulted in 8 cases, of which 4 closed spontaneously within 1 month postoperatively. Meatal stenosis occurred in 1 case.
  
  
  CONCLUSIONS
  This technique is simple, safe and reliable, especially in cases of failed previous operation or for salvage hypospadias repair with deficient local tissue.
authors: Plastic Surgery Hospital, PUMC and CAMS, Beijing, China.
authors: Qiang
authors: Q
authors: Li
authors: Senkai
authors: S
authors: Li
authors: Wen
authors: W
authors: Chen
authors: Jiajie
authors: J
authors: Xu
authors: Mingyong
authors: M
authors: Yang
authors: Yangqun
authors: Y
authors: Li
authors: Yongqian
authors: Y
authors: Wang
authors: Zhenmin
authors: Z
authors: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D010413:Penis / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*