Indications and limitations of buccal mucosa reconstructive urethral surgery in hypospadias repair

Abstract

The first case report on the use of buccal mucosa for urethroplasty dates back to 1894 [1]. In 1941, Humby reported another case [2]. Almost 50years later, Bürger [3] published a series of tubularized free grafts in an animal model that he transferred to patients with hypospadias/ epispadias. Reports on a free transfer of buccal mucosa and bladder mucosa in combination [4] as well as the use for repair of a urethral stricture correction in children followed [5]. Thereafter, the number of publications increased. The main indication for the implementation of buccal mucosa was urethral reconstruction in complex cases such as severe hypospadias cases [6-9] or bladder exstrophy/epispadias [8, 9]. The buccal mucosa was not only used as a tube, but also as an onlay technique [8, 9]. In 1996, the indication was extended to repair of urethral strictures in adults [10, 11] with excellent results.