Extragenital split thickness skin graft for urethral reconstruction

Area of Science:

• Reconstructive Surgery
• Urology
• Pediatric Surgery

Background:

• Severe genital deformities often result from failed previous operative attempts.
• Reconstruction is challenging due to scarred and ischemic surgical fields.
• Hypospadias cripples present limited local genital skin for urethral and penile reconstruction.

Purpose of the Study:

• To evaluate the efficacy of free split-thickness extragenital skin grafts for urethral reconstruction in patients with severe hypospadias.
• To assess the outcomes and complications of this salvage procedure.

Main Methods:

• A free split-thickness graft of extragenital skin was used in 11 male patients (ages 8-21).
• Patients had undergone multiple failed hypospadias or epispadias repairs.
• The technique focused on urethral reconstruction when local skin was unavailable.

Main Results:

• Complications included urethral stricture in 2 patients and fistula in 2 patients.
• Long-term results were excellent with an average follow-up of 4 years.
• The procedure demonstrated utility in salvage situations.

Conclusions:

• Free split-thickness extragenital skin grafting is a useful salvage technique for urethral reconstruction.
• Careful observation of technical points is crucial for successful outcomes.
• This method can be a valuable addition when local tissue is insufficient for hypospadias repair.