Bladder Mucosal Graft for Severe Hypospadias Repair

Shin, Ki Yong; Woo, Young Nam

Abstract

Bladder mucosa has been reported as an excellent tissue for construction of a neourethra. We used bladder mucosa in 3 cases when there was inadequate foreskin to create a neourethra. Two cases were penoscrotal hypospadias with chordee which were repaired in one stage operation and one case was scrotal hypospadias with severe chordee which was repaired in two stage operation. The. sizes of harvested bladder mucosa were 4x 1.5cm, 10 x 3.5cm and 15 x 3cm respectively. Two minor and one major complications occurred. The minor complications were urethral stricture in one case which was managed with urethral dilation and penile swelling after self-voiding in one case which required urinary diversion for several days. In one case severe problem with entire neourethra stricture necessitated internal urethrotomy and intermittent urethral dilatation. In all cases sufficient graft tissue could be obtained and there were no urethrocutaneous fistulas. Thus, the use of bladder mucosal graft in hypospadias repair is feasible in cases in which previous repairs have railed or in which sufficient foreskin for neourethral reconstruction is lacking.