Autologous Free Reverse Inlay Vein Graft in the Treatment of Cripple Hypospadias; an experimental rabbit model

Abstract

Objective: The aim of this study is using the autologous reverse inlay jugular vein graft as a substitute for defective urethral plate and the incorporation of the graft to the urethral plate. Cripple hypospadias are the patients who have a history of previous multiple unsuccessful hypospadias surgery and still having anatomical and functional complications. Insufficient local or support tissue for the repair of defective urethral plate is always a problem. Material and Methods: In the study fourteen male 8-10 months old which is weighting four kg, New Zealand type rabbit are divided into two equal groups. Juguler vein graft (1st group) and buccal mucosal graft (2nd group) harvested and transferred to defective area in the urethral plate as a free flap. Results: In the histopatologic examination, epithelization, fibrosis and inflammation degrees were evaluated between the groups and in-groups. In the histopatological examination of the 1st group, uroepithelization is complete or nearly complete, fibrotic activity is (+) and the inflammation was found minimal. In the second group after 21st day, the uroepithelization on the graft is nearly thirty percent, fibrotic activity is (++) and the inflammation is also found minimal. Conclusion: From the results of the study, in the treatment of defective urethra in cripple hypospadias cases, reverse free juguler vein graft can be used as an alternative for buccal mucosa graft as a substitution material which has been used for a long time.