Perineal approach with penile invagination for one-stage oral mucosa graft urethroplasty in adults with hypospadias-associated strictures.
Perineal oral mucosa graft urethroplasty achieved functional success in most hypospadias-stricture patients
Perineal approach with penile invagination for one-stage oral mucosa graft urethroplasty in adults with hypospadias-associated strictures.
Urethral strictures in adults with a history of childhood hypospadias repair represent a complex reconstructive challenge due to altered anatomy, deficient spongiosum, and frequent use of penile skin in prior repairs.
The aim of this study was to prospectively evaluate the anatomical, functional, and patient-reported outcomes of single-stage oral mucosa graft (oral mucosa graft) urethroplasty performed through a perineal approach with penile invagination in adults with hypospadias-associated urethral strictures.
This prospective, single-center study included adult patients undergoing single-stage dorsal onlay oral mucosa graft urethroplasty via a perineal approach with penile invagination (2022-2024).
most patients regained strong, unobstructed urine flow after surgery
Median stricture length was 6 (IQR, 5-7) cm.
Median urethral caliber improved from 5 (IQR, 4-6) to 16 (IQR, 12-16) Charriere (Ch), and median maximum urinary flow rate (Qmax) from 6 (IQR, 4-8) to 16 (IQR, 12-19) mL/s.
Median urethral stricture surgery-patient-reported outcome measures symptom score improved from 17 (IQR, 16-18) to 3 (IQR, 2-5).
Four patients (36%) developed penile hematoma, two with associated wound dehiscence; all were managed conservatively (Clavien-Dindo I).
Single-stage dorsal onlay oral mucosa graft urethroplasty using a perineal penile invagination approach provides high functional improvement and patient satisfaction in selected adults with hypospadias-associated strictures, while avoiding penile incision and with a low rate of clinically relevant complications.