[Urethroplasty with combined free tissue grafts].
The treatment of the congenital and acquired diseases of the male urethra is a serious health and social problem. The lack of sufficient graft material from the genital area leads to the usage of free tissue grafts from other body parts. The combined usage of different tissue grafts is rare, but with a steady trend for expanding, particularly in patients with complications and deformations after surgery for hypospadia


METHODS
Presenting the initial experience with using combined free tissue grafts in eight patients, aged 19 to 65 years. In 6 (75%) the indication for application of this technique are recurrent urethral fistulas and deformity of glans penis after surgery for hypospadia, and in 2 (25%) case patient with a severe form of Balanitis Xerotica Obliterans (BXO) and long urethral stricture. We used graft material form buccal mucosa and retroauricular skin. The buccal mucosa graft was used for correction of the stricture of the anterior urethra, and the retroauricular skin - for meatoglanuloplasty.


RESULTS
In 75% of the cases we achieved very satisfactory results, consisting of: 1. Full patency of the urethra; 2. Definitive closure of the fistula; 3. Satisfactory correction of the deformity of glans penis. In 1 case we observed recurrence of the fistula, and in another one - formation of new fistula with full patency of the urethra Complications and deformities from the graft site had not been observed.


CONCLUSIONS
initial experience with combined usage of buccal mucosa and free skin graft from the retroauricular area for reconstruction of the male urethra and penis gives promising results, especially in cases with "crippled" hypospadia and with severe forms of Balanitis Xerotica Obliterans (BXO).
Slavov
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D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D016038:Skin Transplantation; D016896:Treatment Outcome; D014522:Urethral Diseases / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*