01
The core question changes
At this point the question is no longer "which technique" but "what do we have left." Which of the penile skin, foreskin, and oral mucosa are still usable determines the entire plan.
Hypospadias Surgery • Recurrent Cases
This page is part of hypospadias surgery.Read the full treatment overview on the hub page
Redo Hypospadias Surgery in Adults
This is a picture where someone has had more than one procedure and problems have persisted. This group is called "salvage surgery"; the plan is built not around standard techniques but around an inventory of the tissue that remains.
Who this is forAdults who have had multiple previous operations
Reading≈2 minByProf. Dr. Ali AvanoğluUpdated
In brief4 madde
- The core question changes: At this point the question is no longer "which technique" but "what do we have left." Which of the penile skin, foreskin, and oral mucosa are still usable determines…
- The problems are addressed together: Stricture, fistula, diverticulum, and curvature are usually all present together in this group, and they feed into one another.
- Options: Staged urethroplasty (Bracka-type) — the standard approach.
- Setting the goal clearly from the start: The most important conversation in this group is this: is the goal a flawless appearance, or trouble-free, predictable voiding?
02
The problems are addressed together
Stricture, fistula, diverticulum, and curvature are usually all present together in this group, and they feed into one another. Trying to fix just one of them does not produce a lasting result.
03
Options
- Staged urethroplasty (Bracka-type) — the standard approach. In the first stage the scar is cleared, curvature is corrected, and the floor is prepared with a graft; in the second stage the channel is constructed.
- Oral mucosa graft — can be taken from the cheek, lower lip, or underside of the tongue.
- Perineal urethrostomy — in some cases, rather than repairing the entire channel, a permanent opening that allows trouble-free voiding while sitting is preferred. It is a legitimate, and sometimes the most appropriate, option.
- Single-stage salvage repair in selected cases — when the remaining tissue is better than expected.
04
Setting the goal clearly from the start
The most important conversation in this group is this: is the goal a flawless appearance, or trouble-free, predictable voiding? The two cannot always be achieved at the same time, and setting the right expectation from the start is the most decisive part of the process.
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Full guide (19) →Frequently asked questions
Why does adult urology experience matter?
The methods used in this group — oral mucosa graft, staged urethroplasty, stricture surgery — are the methods of adult reconstructive urology. Having this experience on the team directly affects the planning.
How long does the process take?
There is roughly 6 months between the two stages; the total process can run past a year. A third session may be needed.
Related pagesFull index →
Surgical TechniquesOral Mucosa GraftThe thin layer of mucosa taken from inside the cheek is the most valuable backup tissue in hypospadias surgery. Because it tolerates a moist environment, and because it is thin and well supplied with blood, it is safely used as the lining for the new urinary channel.Recurrent CasesPerineal UrethrostomyPerineal urethrostomy is the permanent opening of the urinary channel into the perineum (behind the scrotum). Rather than rebuilding the entire channel, it aims to provide reliable, trouble-free urination.Surgery in ChildrenTwo-Stage Hypospadias SurgeryStaged repair is not a second surgery performed because of a complication — it is two steps planned from the very start. The first session prepares the foundation, the tissue matures during the interval, and the channel is built in the second session.Hypospadias in AdultsUrethral Stricture After Hypospadias in AdultsThe channel has narrowed following a repair done years earlier. This is the most common late complication of hypospadias surgery, and it usually appears during adolescence or adulthood.
Hypospadias Surgery topic clustersMain treatment page →
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