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584 Dorsal inlay buccal mucosal graft (Asopa technique) for the repair of large post hypospadias urethrocutaneous fistula
584
Dorsal inlay buccal mucosal graft (Asopa technique) for the repair of large post hypospadias urethrocutaneous fistula Eur Urol Suppl 2016;15(3);e584
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Elgamal S. 1 , Gameel T.1 , Ghalwash M. 1 , Abdelhameed H.2 , Radwan M. 1 , Nagla S. 1 , Lotfy M. 1 1 Tanta
University Hospitals, Dept. of Urology, Tanta, Egypt, 2 Fayoum University Hospitals, Dept. of Urology, Fayoum, Egypt
INTRODUCTION & OBJECTIVES: Asopa described the inlay of a graft into Snodgras’s longitudinal urethral plate incision using a ventral sagittal urethrotomy approach in 2001. We used this principle for management of post-hypospadias large urethrocutaneous fistula. The purpose of this study is to evaluate the effectiveness of dorsal inlay buccal mucosa graft in the management of large urethrocutaneous fistula after hypospadias repair. MATERIAL & METHODS: Our study included 22 patients, who developed a large urethocutaneous fistula(>5 mm) after hypospadias repair from January 2011 to December 2014. The mean age of the patients was 6.5 years. The sites of the fistulae were proximal penile in 4, mid-penile in7 and distal penile in 11 . the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and below the fistula opening and deepened to include the full thickness of the dorsal urethra. Then the graft was fixed as dorsal inlay. All of the patients had been followed for at least 6 months. A successful surgical operation was defined as no fistula recurrence or urethral stricture. RESULTS: Fistula repair using buccal mucosa patch graft had been done in 22 patients. The mean age of the patients was 6.5 years (range,2 to 14 years). The repair was successful in 18 out of 22 cases (81.8%), and in these cases the urinary stream was good after the removal of the catheter. The unsuccessful cases were 2 in distal fistulas and 2 in proximal fistulas. CONCLUSIONS: Buccal mucosal patch graft is a feasible and efficient technique in repairing large urethrocutaneous fistulas after hypospadias with minimal complications and good results.
Dorsal inlay buccal mucosal graft (Asopa technique) for the repair of large post hypospadias urethrocutaneous fistula Eur Urol Suppl 2016;15(3);e584
Print! Print!
Elgamal S. 1 , Gameel T.1 , Ghalwash M. 1 , Abdelhameed H.2 , Radwan M. 1 , Nagla S. 1 , Lotfy M. 1 1 Tanta
University Hospitals, Dept. of Urology, Tanta, Egypt, 2 Fayoum University Hospitals, Dept. of Urology, Fayoum, Egypt
INTRODUCTION & OBJECTIVES: Asopa described the inlay of a graft into Snodgras’s longitudinal urethral plate incision using a ventral sagittal urethrotomy approach in 2001. We used this principle for management of post-hypospadias large urethrocutaneous fistula. The purpose of this study is to evaluate the effectiveness of dorsal inlay buccal mucosa graft in the management of large urethrocutaneous fistula after hypospadias repair. MATERIAL & METHODS: Our study included 22 patients, who developed a large urethocutaneous fistula(>5 mm) after hypospadias repair from January 2011 to December 2014. The mean age of the patients was 6.5 years. The sites of the fistulae were proximal penile in 4, mid-penile in7 and distal penile in 11 . the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and below the fistula opening and deepened to include the full thickness of the dorsal urethra. Then the graft was fixed as dorsal inlay. All of the patients had been followed for at least 6 months. A successful surgical operation was defined as no fistula recurrence or urethral stricture. RESULTS: Fistula repair using buccal mucosa patch graft had been done in 22 patients. The mean age of the patients was 6.5 years (range,2 to 14 years). The repair was successful in 18 out of 22 cases (81.8%), and in these cases the urinary stream was good after the removal of the catheter. The unsuccessful cases were 2 in distal fistulas and 2 in proximal fistulas. CONCLUSIONS: Buccal mucosal patch graft is a feasible and efficient technique in repairing large urethrocutaneous fistulas after hypospadias with minimal complications and good results.