Long-Term Results of Buccal Mucosa Onlay Grafts in Hypospadias Repair
Purpose Buccal mucosa onlay grafts are widely used in complex Hypospadias surgery. In a retrospective study we evaluated the long-term results in patients with a minimum follow-up of 5 years. Material and Methods All patients in who underwent buccal mucosa grafting for Hypospadias repair in our institution received a questionnaire and were invited for a follow-up visit. The questionnaire included two visual analogue scales (VAS) concerning the functional and cosmetic result (0 = very dissatisfied; 50 = satisfied; 100 = very satisfied). Results A total of 85 patients with a median age at the operation of 7.4 years (1 – 60 years) could be followed for a median of 8 years (5-16 years). In 36/85 the buccal mucosa had been used in a redo-operation. For functional results, the median VAS score was 86 and for the cosmetic results, the median VAS score was 69.5. The median IPSS (international prostate symptom score) was 2; seven patients reported moderate symptoms and one had a IPSS of 25. 22 patients (26%) developed 24 complications: fistula (5), meatal stenosis (7), wound dehiscence (6), urethral stricture (3) (two strictures after 8 and 9 years were treated by optical urethrotomy) and one granuloma. 19 patients required re-operation, 3 patients were treated conservatively (2 with fistula and one with wound dehiscence). Conclusions After a median follow-up of 8 years, the overall complication rate is acceptable and confirms the durability of buccal mucosa in the long run. Proximal urethral stricture was the most common late complication.