Autologous buccal mucosal graft for urethral reconstruction

: Proximal hypospadias are a difficult surgical problem, whether it could take place different surgical approaches. One of those is based on the creation of a neourethra using a free buccal mucosal graft, as a patch or a tube, obtained from de lips or cheek. Since 1983 we have been using this technique in 8 patients. The urethral meatus was penoscrotal in 3, scrotal in 3 and perineal in 2. There was a significant chordee in 3 patients. Hormonal treatment was necessary in 5 patients. The average age for surgery was 3.5 years. The graft was tubularized in all the cases. The free buccal mucosal graft was combined with a distal Duckett procedure in 6 patients. Two patients received only a free buccal mucosal graft. The final result is satisfactory in all the cases, with a good urinary jet. The complications were 7 urethrocutaneous fistulas, 5 of whom needed a surgical repair, and 2 stenosis, which also needed surgical repair.