Buccal inlay skin onlay: Preliminary report of a one stage technique in cripple hypospadias surgery

Hypospadias failure is a challenging problem requiring much of expertise and perseverance for repair. Most of the time a healthy tissue must be grafted in place of scarred tissue. These techniques are usually accomplished in multiple surgical sessions since primary graft tubularization has been linked with increased complications Patients and method: Eleven patients with mid shaft to distal hypospadias underwent repair. Each patient had under gone two or three unsuccessful surgical attempts for hypospadias repairs. All salvage reconstructive operations were performed on chief responsibility of a single surgeon. The average follow up was 2.5 years. The surgical technique was improvisatory called BISO(Buccal inlay, Skin Onlay) Results: Nine patients had tip meatus and straight voiding. In two cases glandular regression and spraying of urine stream was seen. In both of these cases Peri meatal based rhomboid flaps had been used. No fistula or stricture happened during follow up. In all nine cases parents were satisfied although we did not apply any scoring system, standardized questionnaire or reference pictures to which parents could compare cosmetic results Conclusion: BISO is a viable option in distal hypospadias cases with scarry plate sparing them a second session of surgery in many instances.