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Related Experiment Videos

Coronal cuff: a problem site for buccal mucosal grafts.

E B Yerkes1, M C Adams, D A Miller

  • 1Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

The Journal of Urology
|September 24, 1999
PubMed
Summary

Buccal mucosal grafts are effective for complex hypospadias and epispadias repairs when penile skin is limited. Fistulas, particularly at the coronal cuff, are the most common complication, requiring careful attention to skin coverage.

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Area of Science:

  • Urology
  • Reconstructive Surgery

Background:

  • Hypospadias and epispadias repair presents challenges, especially in complex cases.
  • Buccal mucosa grafts offer an alternative when penile skin is insufficient.

Purpose of the Study:

  • To identify factors influencing the success and failure of buccal mucosal graft urethroplasty.
  • To analyze complications associated with buccal mucosal grafts in urethral reconstruction.

Main Methods:

  • Retrospective analysis of 34 buccal mucosal grafts in 31 patients over 6 years.
  • Grafts used for complex hypospadias/epispadias with limited penile skin, including onlay, tube, and pieced configurations.
  • Average of 5 prior unsuccessful repairs in 16 complicated cases.

Main Results:

Related Experiment Videos

  • Fistula occurred in 13 grafts, predominantly on the distal shaft and coronal cuff.
  • Anastomotic stricture was observed in 5 patients.
  • Fistulas were more frequent with tube and pieced grafts compared to onlay grafts.

Conclusions:

  • Fistula is the primary complication of buccal mucosal graft urethroplasty.
  • Coronal cuff fistulas suggest issues with skin coverage and blood supply in that region.
  • Prioritizing distal penile skin coverage is crucial for successful reconstruction.