Buccal mucosal graft for secondary hypospadias repair and urethral replacement.

Objective: To assess the effectiveness of buccal mucosa in the treatment of complex hypospadias.

Methods: Seventeen patients had an onlay patch of buccal mucosa to reconstruct the urethra after failed previous surgery; five had a tubed buccal mucosal graft as an urethral replacement in the 'primary' repair of severe hypospadias.

Results: There were no complications in 19 patients; two developed fistulae and one a stricture due to graft narrowing. There were no meatal complications.

Conclusions: Buccal mucosa taken from the inner aspect of the lip is very suitable for reconstructing a failed hypospadias repair, especially when used as an onlay graft.