One stage repair of hypospadias using meatal-based flap overlapping with buccal mucosal graft

Objective: To explore the feasibility of one-stage repair of hypospadias using the meatal-based flap overlapping with buccal mucosal graft.

Methods: From March 2002 to May 2004, 21 patients with hypospadias were treated with the meatal-based flap overlapping with buccal mucosal graft. Their ages ranged from 14 months to 8 years. The procedure were as follows: urethral plate at proximal corona was cut to correct glandular tilt and chordee; the buccal mucosa taking from inner cheek was then fixed on tunica albuginea of ventral shaft with suture; and the meatal-based flap was rotated distally and overlaid with buccal mucosal graft to repair urethra.

Results: All patients were followed up 3-18 months (7 months on average). A cosmetic glans and a vertically oriented, normal appearing slit meatus were achieved. Two patients had fistulas on lateral corona. Fistula spontaneously healed in 1 case and the other one was repaired after 6 months.

Conclusions: The technique of meatal-based flap overlapping with buccal mucosal graft can completely correct glandular tilt and chordee, prove good cosmetic and functional glans and meatus.