title: [Urethral reconstruction in severe hypospadias using buccal mucosa graft and penile skin flap].
abstract: BACKGROUND
  Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. Many various tissues are used (local skin flaps, bladder mucosa grafts, buccal mucosa grafts etc.) for the reconstruction of the neourethra.
  
  
  OBJECTIVE
  Our aim was to evaluate advantages and disadvantages of combined buccal mucosa graft and penile skin flap in urethral reconstruction in severe hypospadias repair.
  
  
  METHODS
  Between December 2005 and August 2009, 48 patients with severe hypospadias, aged from nine months to 12 years (mean age 23 months) underwent surgery. Thirty-four (71%) had penoscrotal and 14 (29%) scrotal hypospadias. Ventral penile curvature was present in all cases, and was corrected by incision of the short urethral plate. Urethroplasty was performed a buccal mucosa graft combined with dorsal penile skin flap.
  
  
  RESULTS
  Mean follow-up was 22 months (range from 9 months to 3 years). Satisfactory functional and aesthetic results were achieved in 40 (83%) patients. Fistula was noted in six cases and was solved by minor revision. Urethral stenosis in two cases was resolved by simple dilatation.
  
  
  CONCLUSIONS
  Urethral reconstruction using the buccal mucosa graft and dorsal penile skin flap in severe hypospadias repair could be the method of choice. Using this technique, single stage urethral reconstruction is possible with satisfactory esthetical and functional results.
authors: Marko
authors: M
authors: Majstorović
authors: Marta
authors: M
authors: Bižić
authors: Vladimir
authors: V
authors: Kojović
authors: Borko
authors: B
authors: Stojanović
authors: Zoran
authors: Z
authors: Krstić
authors: Miroslav
authors: M
authors: Djordjević
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation; D010413:Penis; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*