Tubed Free Skin Graft for Construction of Male Urethra

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Abstract
A tubed, free skin graft was used to construct a urethra in 49 young male subjects. Indications included multiple previous hypospadias operations, new severe hypospadias cases, chordee without hypospadias but with a short urethra, epispadias, distal urethral stricture and a small number of patients undergoing an initial operation for hypospadias by the Horton-Devine technique. No fistulas or leaks occurred. The over-all complication rate was low. Based on the authors'' experience and that reported by others it is believed that a free tubed graft is an excellent method for making a substitute urethra in a variety of urethral problems in children and young adults. It is important that the graft is of full or nearly full thickness because thin grafts tend to contract.