The Bladder Mucosal Graft Technique for Hypospadias Repair

A technique for the repair of severe hypospadias is described. The essential features include a chordee release and cosmetic repair of the previously tethered penis, the construction of a new urethra using bladder mucosa in a subcutaneous tunnel and an oblique anastomosis of the graft and true urethra as deep within the shaft of the penis as possible. One stricture has developed with this technique and meatal stenosis requiring dilation remains a minor problem. However, the over-all results of this technique appear to be good. The use of bladder mucosal grafts in cases in which previous repairs have failed or in which adequate foreskin for urethral reconstruction is lacking is feasible and has been performed successfully in adults. THe combination of a chordee release and bladder mucosal inlay graft as a single stage procedure in a small child has not yet been attempted.