Autologous buccal mucosal graft for urethral reconstruction.

Objectives: The search for an adequate tissue for reconstruction of the urethra in those patients with a paucity of local skin continues. Over the past 18 months, the use of buccal mucosa as a substitution for urethra was evaluated.

Methods: Six patients who had complex hypospadias had buccal mucosa grafts for urethral reconstruction. All patients had had previous surgery for repair of chordee or significant complications from previous surgery with a result of lack of penile skin. Patients were operated on and followed for 8 to 17 months.

Results: Buccal mucosa was used as a rolled tube in 4 patients, an onlay graft in 1, and a folded tube in 1. A urethrocutaneous fistula that was repaired 6 months after the buccal surgery was the only complication.

Conclusions: By virtue of its tissue characteristics, ease of handling, and ease of harvest, buccal mucosa is an excellent tissue for urethral reconstruction.