MP65-10 DOES OPERATIVE DECISION-MAKING FOR TUNNELED BUCCAL MUCOSAL GRAFT IMPACT THE RISK OF FAILURE?

Abstract

You have accessJournal of UrologyPediatrics: Hypospadias and Penile Surgery (MP65)1 Apr 2020MP65-10 DOES OPERATIVE DECISION-MAKING FOR TUNNELED BUCCAL MUCOSAL GRAFT IMPACT THE RISK OF FAILURE? Preeya Mistry*, Vinaya Bhatia, Jennifer Reifsnyder, Tavya Benjamin, Ronnie Fine, Jordan Gitlin, Paul Zelkovic, and Lane S. Palmer Preeya Mistry*Preeya Mistry* More articles by this author , Vinaya BhatiaVinaya Bhatia More articles by this author , Jennifer ReifsnyderJennifer Reifsnyder More articles by this author , Tavya BenjaminTavya Benjamin More articles by this author , Ronnie FineRonnie Fine More articles by this author , Jordan GitlinJordan Gitlin More articles by this author , Paul ZelkovicPaul Zelkovic More articles by this author , and Lane S. PalmerLane S. Palmer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000940.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Buccal mucosa is useful graft material for repair of complex and previously failed hypospadias repairs. Since 2007, we have used the tunneled buccal mucosa tube graft urethroplasty technique in both primary and redo proximal hypospadias repairs. Our objective was to demonstrate the relationship between operative decisions and the risk of postoperative complications. METHODS: We conducted an IRB-approved, single-center, retrospective study of patients undergoing a tubularized buccal mucosal graft for primary or redo hypospadias repair. In all cases, the first stage optimized the penile shaft (chordee correction with dermal graft, skin rearrangement). In the second stage, a buccal graft was tubularized and passed subcutaneously to the glanular tip. The anastomosis to the native urethra was covered with tunica vaginalis, dartos, or a combination. Repair failure in this study was defined as any resultant surgical complication. Descriptive statistics, Chi-squared tests, and non-parametric tests [Mann-Whitney U Tests, Kruskal-Wallis Tests] were used to compare the intraoperative decisions made between patients experiencing complications and patients without complications. RESULTS: 131 patients met inclusion criteria, of which 96 (73.3%) were primary repairs. The mean age at the time of repair was 58.3 months (range 7-510). The average graft measured 4.8 cm length (range 2-12cm) by 1.96 cm width (1-18 cm), for a mean graft area of 9.4 cm2 (range 3-90 cm2). On Kruskal-Wallis test, graft length (p = 0.055), width (p = 0.903), and graft area (p = 0.158) were not significantly associated with the risk of development of complications. Of the other operative decisions explored, longer duration of suprapubic tube (p = 0.021) was significantly associated with repair failure on Kruskal-Wallis Test. CONCLUSIONS: The tubularized buccal graft technique has been used as a suitable option at our institution for management of complex proximal or revision hypospadias repairs. We present a large cohort of patients after this repair and demonstrate that graft size did not affect chances of graft failure. Of note, consideration for early removal of suprapubic catheters in these patients may contribute to fewer complications. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e977-e977 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Preeya Mistry* More articles by this author Vinaya Bhatia More articles by this author Jennifer Reifsnyder More articles by this author Tavya Benjamin More articles by this author Ronnie Fine More articles by this author Jordan Gitlin More articles by this author Paul Zelkovic More articles by this author Lane S. Palmer More articles by this author Expand All Advertisement PDF downloadLoading ...