The aim of this study was to retrospectively investigate the outcomes of patients who underwent one-stage onlay or inlay urethroplasty
using a lingual mucosal graft (LMG) after failed hypospadias repairs. Inclusion criteria included a history of failed hypospadias repair,
insufficiency of the local skin that made a reoperation with skin flaps difficult, and necessity of an oral mucosal graft urethroplasty.
Patients were excluded if they had undergone a failed hypospadias repair using the foreskin or a multistage repair urethroplasty.
Between January 2008 and December 2012, 110 patients with failed hypospadias repairs were treated in our center. Of these
patients, 56 underwent a one-stage onlay or inlay urethroplasty using LMG. The median age was 21.8 years (range: 4–45 years).
Of the 56 patients, one-stage onlay LMG urethroplasty was performed in 42 patients (group 1), and a modified Snodgrass
technique using one-stage inlay LMG urethroplasty was performed in 14 (group 2). The median LMG urethroplasty length was
5.6 ± 1.6 cm (range: 4–13 cm). The mean follow-up was 34.7 months (range: 10–58 months), and complications developed in
12 of 56 patients (21.4%), including urethrocutaneous fistulas in 7 (6 in group 1, 1 in group 2) and neourethral strictures in 5
(4 in group 1, 1 in group 2). The total success rate was 78.6%. Our survey suggests that one-stage onlay or inlay urethroplasty
with LMG may be an effective option to treat the patients with less available skin after failed hypospadias repairs; LMG harvesting
is easy and safe, irrespective of the patient’s age

Keywords: failed repair; hypospadias; lingual mucosa graft; urethroplasty

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