Staged Buccal Mucosa Transplantation in Treating Secondary Penile Curvature after Hypospadias Surgery and Curative Effect Analysis
To explore the treatment and postoperative effect of applying oral mucosal piece or reelpipe in treating secondary penile curvature after congenital hypospadias repair. One-stage surgery: the ventral contracture fiber tissues of the penis were completely removed surgically, the original reconstructed urethra was transected and the surrounding tissues were released to straighten the penis and the oral mucosal piece or reelpipe was applied in reconstructing the urethral defect. Two-stage surgery: urethral anastomosis was performed after confirming that the transplanted oral mucosa had survived, and the pedicle scrotal island flap was used to cover the ventral wound surface. At 6 months postoperatively, the penis lengths under flaccid and erectile states were measure to evaluate the surgical effect and observe the incidence of postoperative complications. From July 2010 to February 2019, 87 male patients aged 17-28 years (average, 22.4 years) were repaired in clinic, among them, 85 cases were followed up from 6 months to 3 years postoperatively (average, 30.5 months) by means of telephone, network, and patient clinical reexamination, while the remaining 2 were lost to follow-up due to changes in address and telephone. Among these 85 patients, the penis extended for 2.81±0.58 cm under flaccid state and 2.9±0.28cm under erectile state , 8 cases had urinary fistula, while the remaining patients had excellent urination and range, with no complications such as urethral stricture, urethral retraction or urinary fistula; besides, the penile curvature was excellently corrected, and no recurrence was reported. After penile straightening, the application of oral mucosal piece or reelpipe in reconstructing urethra, the supplementation of the defective penile ventral tissues, and the two-stage application of scrotal island flap to cover the wound surface to reduce the ventral tension, contribute to treating the secondary penile curvature and avoid postoperative recurrence, without shortening the penis length and perimeter.