PD22-11 DONOR SITE COMPLICATIONS FOLLOWING URETHROPLASTY WITH ORAL MUCOSAL GRAFT: ANALYSIS OF 442 PATIENTS WITH URETHRAL STRICTURE

Abstract

Baskin modification (10 pts) and two stage corporal-dermal grafting (15 pts). 172 patients presented with micturitional abnormalities (straining, spraying or leakage) and or cosmetic concerns of whom 36 pts had urethral stricture, 11 pts had BXO, 5 developed hairy urethra of whom 2 had urethral stone, and 3 pts had urethral diverticulum. 117 patients complained of spraying of urine and/or had esthetic concerns RESULTS: 186 patients underwent one stage surgical repair, and staged repair was performed in 37 pts. The follow up of 31 pts was 2 weeks and in 192 pts the follow up varied between three months to five years with a median of 18 months. Early in the series we encountered wound infections in 12 patients resulting in dehiscence of the repair. The early and late complication rates were: 21/186 (11%) of the one stage repair group,and 10/37 (27%) in the multi-staged repair group CONCLUSIONS: Complications of childhood hypospadias repair may present later in life and it would appear that some urethroplasties deteriorate with time. Urethral strictures may appear many years later and penile curvature can recur in some cases of proximal hypospadias. Furthermore esthetics acquire greater importance during adolescence and spraying from a sub-terminal or irregular meatus accounted for more than 50% of the complaints in this series. We have recommended to the parents of repaired hypospadias children especially for those with proximal hypospadias to come for follow up as their child transitions to adolescence. The patients are advised to use antiseptic soap the evening prior to and the morning of surgery. Currently we avoid prolonged catheterization which in conjunction with nocturnal erections can cause shearing movements between the sutured margins and the catheter. We therefore prefer using urine drainage via suprapubic cystotomy and brief urethral stenting for the more extensive repairs