Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

193 / 492

11:05 - 11:08
S14-9 (PP)
VENTRAL BUCCAL MUCOSA GRAFTING FOR SIMOULTANEOUS CURVATURE
REPAIR AND URETHROPLASTY IN THE TREATMENT OF PROXIMAL HYPOSPADIAS:
A NOVEL TECHNIQUE
Miroslav DJORDJEVIC1, Marta BIZIC2, Borko STOJANOVIC2, Vladimir KOJOVIC3 and Marko MAJSTOROVIC4
1) University Children's Hospital, Paediatric Surgery/Urology, Belgrade, SERBIA - 2) University Children's Hospital,
Urology, Belgrade, SERBIA - 3) Instutute for mother and child's health care, Urology, Belgrade, SERBIA - 4) University
Children's Hospital, Plastic Surgery, Belgrade, SERBIA
PURPOSE
Penile straightening with urethral reconstruction present a great challenge in severe hypospadias repair. We evaluated a
novel method of using ventral buccal mucosa grafting for simultaneous curvature repair and urethroplasty in the
treatment of severe hypospadias.
MATERIAL AND METHODS
Between March 2013 and October 2014, 15 patients (aged from 10 to 22 months) underwent severe hypospadias repair
(11 penoscrotal and 4 scrotal forms). Short urethral plate is mobilized and divided at the point of maximal curvature in
all cases. Tunica albuginea is opened ventrally to straighten and lengthen the curved penis. Appropriate sized and
shaped buccal mucosa graft is harvested from inner cheek and fixed to the ventral side of corpora cavernosa to cover
tunical defect and create dorsal part of the neourethra, simultaneously. Longitudinal dorsal island skin flap is created
and buttonholed ventrally. It is sutured together with buccal mucosa graft to form the neourethra. Abundant pedicle of
the skin flap is fixed laterally to cover all suture lines of new created urethra. Penile skin reconstruction is done using
available penile skin.
RESULTS
The mean (range) follow-up was 14 (4 - 21) months. Satisfactory results have been achieved in 13 patients. There was
no report of residual curvature. Only two urethral fistulas occurred and successfully corrected three months after
surgery.
CONCLUSIONS
Buccal mucosa graft could be a good choice for simultaneous ventral penile straightening and urethral reconstruction in
most severe hypospadias repair. This way, mobilization of the neurovascular bundle and dorsal plication is avoided.