Reconstruction of failed urethroplasty with different tissues and materials for hypospadias

Objective To study the efficacy and complications of reconstruction of failed urethro-plasty for hypospadias with pedicle flap , bladder mucosa , buccal mucosa , and biological patch . Methods 23 patients were enrolled from Jul .2005 to Dec.2011.8 patients, with good local skin condition , were performed with pedicle flap urethroplasty .The other 15 patients, with bad local skin condition or with long segment urethral stricture , were performed with free grafts , including 6 bladder mucosa , 7 buccal muco-sal and 2 biological patch. Results Of the 23 cases, 7 cases were cured by one phase operation .There were 16 （16/25） cases had complications.3 （3/16） cases were failed because of serious infection （2 pedi-cle flap, 1 bladder mucosa ） .The failed cases were implemented with urethroplasty 6 months later by the buccal mucosa installments operation .4 （4/16） cases had solitary urethral fistula （1 pedicle flap, 2 bladder mucosa, and 1 buccal mucosal）, who were successfully treated with simple fistula repair 3 to 6 months later. 9 （ 9/16） cases had urethral stricture （ 2 pedicle flap , 3 bladder mucosa , 3 buccal mucosal , and 1 biologi-cal patch graft ） , who were treated with urethral sound and got good result .We had reconstructed the urethra using mucosa graft onlay urethroplasty .All of the 23 patients were followed up with an average of 14.5 （ 6-24） months.23 cases were satisfied with the stretched penis , urination and no need to expand the urethra more than 6 months.3 cases were not satisfied with penile appearance .After communication, these patients did not require a further penis orthopedic surgery . Conclusions Pedicle flap, bladder mucosa , buccal mucosa and biological patch can be used in urethral repair and construction of failed urethroplasty for hypos -padias.Urethral sound dilation plays an important role in hypospadias repair . Key words: Hypospadias; Urethroplasty; Pedicle flap; Bladder mucosa; Buccal mucosa; Biological patch