Lip mucosal graft dorsal inlay widening urethroplasty for post-pubertal hypospadias failures: An exploratory surgery

We explored a "widening surgery" utilizing dorsal stricturotomy and lip mucosal graft inlay for post-pubertal long-segment urethral strictures (LSS). In 8 adolescents (median age 16.3 years), 6 underwent single-stage and 2 underwent planned two-stage repair due to infection. At a median follow-up of 39 months, the primary success rate was 87.5 % (7/8). One fistula occurred and was successfully repaired. Median maximum urinary flow (Qmax) improved from 4.4 to 24.5 ml/s. This study suggests dorsal inlay widening urethroplasty is a feasible strategy for complex LSS, preserving the urethral plate, though larger validation studies are required.