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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2018, Number 3

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An Med Asoc Med Hosp ABC 2018; 63 (3)

Free graft total urethroplasty with buccal

Rodríguez WLO, Martínez RMR, Piña RLD, Velázquez VC

Language: Spanish
References: 11
Page: 221-224
PDF size: 272.91 Kb.


ABSTRACT

Hypospadias is a congenital anomaly of the urogenital system managed through several procedures: more than 300 have been described in the literature. However, they are associated with complications such as fistulas and stenosis. Repeated attempts at the surgical repair of hypospadias may leave the penis scarred, hypovascular and short. The use of oral mucosa to repair penile and bulbar urethral stenosis was first described in 1993. Today, oral mucosa is considered ideal due to its structural characteristics, which make it a versatile tissue, adaptable for urethral reconstructive surgery. The two-stage Bracka correction for the repair of hypospadias is a versatile technique applicable to all varieties of hypospadias, mainly the severe ones and those that present complications. A staggered repair is performed, with a full-thickness free buccal mucosal graft. This will serve as a neourethral plate, with a reconstruction of the urethra six months later. This is a reliable method for the functional reconstruction; in addition, it provides a good aesthetic and an almost normal appearance of the penis.


REFERENCES

  1. Snodgrass W, Yucel S. Tubularized incised plate for mid shaft and proximal hypospadias repair. J Urol. 2007; 177 (2): 698-702.

  2. Snodgrass W, Bush N. Tubularized incised plate proximal hypospadias repair: Continued evolution and extended applications. J Pediatr Urol. 2011; 7 (1): 2-9.

  3. Gill NA, Hameed A. Management of hypospadias cripples with two-staged Bracka’s technique. J Plast Reconstr Aesthet Surg. 2011; 64 (1): 91-96.

  4. Barbagli G, Balò S, Montorsi F, Sansalone S, Lazzeri M. History and evolution of the use of oral mucosa for urethral reconstruction. Asian J Urol. 2017; 4 (2): 96-101.

  5. Snodgrass WT, Bush N, Cost N. Algorithm for comprehensive approach to hypospadias reoperation using 3 techniques. J Urol. 2009; 182 (6): 2885-2891.

  6. Snodgrass W, Bush NC. Re-operative urethroplasty after failed hypospadias repair: how prior surgery impacts risk for additional complications. J Pediatr Urol. 2017; 13 (3): 289.e1-289.e6.

  7. Mitsukawa N, Saiga A, Akita S, Kubota Y, Kuriyama M, Satoh K. Two-stage repair for severe proximal hypospadias using oral mucosal grafts: combination of a modified Bracka method and a modified Byars flap method. Ann Plast Surg. 2015; 74 (2): 220-222.

  8. Snodgrass W, Elmore J. Initial experience with staged buccal graft (Bracka) hypospadias reoperations. J Urol. 2004; 172 (4 Pt 2): 1720-1724; discussion 1724.

  9. Snodgrass W, Macedo A, Hoebeke P, Mouriquand PD. Hypospadias dilemmas: a round table. J Pediatr Urol. 2011; 7 (2): 145-157.

  10. Snodgrass W, Bush N. Staged tubularized autograft repair for primary proximal hypospadias with 30-degree or greater ventral curvature. J Urol. 2017; 198 (3): 680-686.

  11. Snodgrass W. A farewell to chordee. J Urol. 2007; 178 (3 Pt 1): 753-754.




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