Buccal versus lingual mucosal graft urethroplasty for complex hypospadias repair

Objectives: To compare surgical outcomes and donor site complications of buccal and lingual mucosa used as ventral onlay graft for complex hypospadias cases. Patients \& methods: Forty four cases with complex hypospadias after failed previous surgery were prospectively included. All had severely scarred penile skin with reasonable residual urethral plate. Cases were categorized into two groups: Group I (23) where buccal mucosal graft {[}BMG] was used and group II (21) where lingual mucosal graft {[}LMG] was used. Donor site complications as well as functional and esthetic outcomes were recorded for each group. Results: Mean follow up was 20.8 months (range 12-24). Average graft harvesting time was 24 min for BMG and 19 min for LMG. Donor site pain was reported with both techniques but recovery was earlier with LMG. Slurred speech and difficult tongue protrusion were reported with lingual but not buccal grafts; however mouth tightness, peri-oral numbness and persistent oral discomfort were reported only with buccal grafts. Successful urethroplasty was obtained in 78.2\% of BMG compared to 76.1\% of LMG. Conclusion: Surgical outcomes of LMG urethroplasty were comparable to those of BMG in complex hypospadias cases. Compared to buccal mucosa, LMG is easy to harvest, with minimal donor site complications. (C) 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.