[Urethral reconstruction using gelatin sponge and micro-mucosa graft combined with local flap]

To introduce an operative method of combining the complex of gelatin spongy and micromucosa from inner prepuce or urethral plate graft with the local flap in the treatment of scrotal hypospadias and penoscrotal hypospadias and to investigate its therapeutical effect.

From April 2006 to December 2007, 8 cases of congenital hypospadias were treated, aging 8 months to 3 years. Three cases were scrotal hypospadias, the others were penoscrotal hypospadias. The length of penis was 2.5-4.5 cm. All cases were repaired with micro-mucosa which taken from inner prepuce or urethral plate, gelatin sponge and local flap. The size of the local flap was 2.5 cm x 1.0 cm-4.5 cm x 1.2 cm. Only one of the 8 cases underwent two-stage operation, and 7 cases underwent one-stage operation.

The operation time was (150 +/- 35) minutes. The length of repaired urethra was (3.38 +/- 0.79) cm. All flaps survived after operation. Eight cases were followed up for 2-24 months. All cases were successful without urethral fistula and urethral stricture postoperatively. A vertically oriented, slit neomeatus was gained after operation and satisfactory voiding function. The appearance of penis resembled the appearance after prepuce circumcision. All the patients have normal urination and erection. Superficial penile curvature occurred in one case after 12 months postoperatively.

Gelatin sponge and micro-mucosa from inner prepuce or urethral plate graft combined with local flap can repair the scrotal hypospadias and penoscrotal hypospadias. The advantages are to decrease the utilization of local tissues, improve the appearance of glans and decrease the complication rates.