Buccal Mucosa Graft And Local Tissue Flap In Complex Hypospadias Repair One Stage Versus Two Stages

hypospadias is the second most common congenital malformation in males, occurring in approximately one in 125 live male births (Manson and Carr, 2003).It is often difficult to obtain sufficient tissue for urethral reconstruction in patients with severe hypospadias or after repeated failed operations (Qiang et al., 2005).The use of buccal mucosa for urethral reconstruction was first suggested by Humby in 1941 (Humby, 1941), this technique was completely forgotten until the 1990s. The interest in buccal mucosa was partly triggered by Burger, R. A. et al. publication in 1992, (Burger et al., 1992).The techniques of buccal mucosa urethroplasty are various. The patch placed either by ventral or dorsal onlay techniques or by one stage tube repair (Barbagli et al., 2005). Also the staged buccal mucosa graft (Bracka procedure) has gained acceptance in hypospadias surgery, (Bracka, 1995a).This study includes 32 patients with complex hypospadias who underwent ventral onlay buccal mucosa graft urethroplasty with local tissue flap as a second layer coverage of the new urethra.