Preliminary Report of a One-stage Technique in Failed Hypospadias Surgery

Hypospadias failure is a challenging problem requiring much expertise and perseverance for repair. Most of the time a healthy tissue must be grafted in the place of scarred tissue. These techniques are usually accomplished in multiple surgical sessions since primary graft tubularization has been linked with increased complications

A total of 11 patients with the mid shaft to distal hypospadias underwent repair. Each patient had undergone two or three unsuccessful surgical attempts for hypospadias repairs. All salvage reconstructive operations were performed on the chief responsibility of a single surgeon. The average follow-up was 2.5 years. The surgical technique was improvisatory called Buccal inlay, Skin Onlay (BISO).

In this study, nine patients had tip meatus and straight voiding. In two cases, glandular regression and spraying of urine stream were observed. In both of these cases, Perimeatal-based rhomboid flaps had been used. No fistula or stricture happened during follow-up. In all nine cases, the parents were consent although we did not apply any scoring system, standardized questionnaire, or reference pictures with which parents could compare cosmetic results.

It can be concluded that BISO is a viable option in distal hypospadias cases with scarry plate sparing them a second session of surgery in many instances.