Efficacies of lingual versus buccal mucosal grafts for multiple failed hypospadias in children

Abstract

Objective To compare the outcomes of buccal versus lingual mucosal grafting for multiple failed hypospadias of children. Methods We have collected 62 children receiving buccal or lingual mucosal grafts from 2012 to 2015. The age range was 3.5-11 years. All cases of multiple failed hypospadias were operated for 2-4 times. All of them were redone with one-stage operation. Thirty-three cases received lingual mucosa graft. The mean age was (7.5±0.2) (3.5-11) years and mean operative frequency (2.8±0.7) (2-4) times. The area of grafts: width: 0.5-1 cm, length: 2-5 cm. The mean follow-up period was 1.3 (5/12-2) years. And 25 patients received lingual mucosal graft and 23 buccal lingual mucosal graft. The mean area of grafts: mean width: (1.2±0.21) (0.5-1.5) cm, mean length: (5.1±0.22) (2-6) cm. The mean follow-up period was (8.3±1.3) (5/12-1) years. Further 29 cases received buccal mucosa graft. The mean age was (7.0±0.5) (4-9.2) years and mean operative frequency (2.5±0.2) (2-4) times. The area of grafts: mean width: (1.0±0.11) (0.5-1.5) cm, mean length: (4.5±0.14) (2-5.3) cm. The mean follow-up period was (5-12) months. And 25 patients received lingual mucosal graft while 23 buccal lingual mucosal graft. The mean area of grafts: mean width: (1.2±0.21) (0.5-1.5) cm, mean length: (5.1±0.22) (2-6) cm. The mean follow-up period was (7.6±0.7)(5-12) years. The results were tested by SPSS 18.0. Rates of complications were compared by chi-square and t tests. Results There were no significant inter-group differences in age, preoperative times, length and width of grafts. No significant inter-group differences existed. Lingual mucosal graft group: fistula: 2/29(6.8%), stricture: 1/33(3.0%) and ventral curcature: 2/33(6.0%). Complications: 5/29(17.0%), successful rate: 24/29(83.0%), Hose score: 14.28±0.12; buccal mucosal graft group: fistula: 2/29(6.8%), stricture: 2/29(6.8%) and ventral curcature: 1/29(3.4%). Complication rate: 5/29(17.0%), successful rate: 24/29(83.0%), Hose score: 14.28±0.12. No inter-group differences existed in overall success, complication rate or Hose score. Conclusions Lingual and buccal mucosal grafts have achieved excellent outcomes. And lingual mucosal graft is superior to buccal mucosa graft so that it offers a viable option for multiple failed hypospadias in children. Key words: Hypospadias; Lingual mucous membrane; Oral mucosa