01
What is it?
A chronic disease affecting the skin and mucosa. It tends to involve the urinary opening and the final part of the channel; the tissue it affects loses its elasticity, turns white, and narrows.
Hypospadias Surgery • Recurrent Cases
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Lichen Sclerosus (BXO)
If white, hardened, shiny tissue is seen around the urinary opening, lichen sclerosus may be present. This finding isn't a minor detail — it's a diagnosis that changes the entire surgical plan.
Who this is forAnyone who notices white, hardened tissue
Reading≈1 minByProf. Dr. Ali AvanoğluUpdated
White, hardened tissue
Normal
In brief4 madde
- What is it?: A chronic disease affecting the skin and mucosa.
- Why is it critical from a surgical standpoint?: Diseased skin cannot be used as a graft.
- Treatment: In the early stage, topical medication (ointments containing a potent corticosteroid) can slow the disease; it doesn't always make surgery unnecessary.
- Follow-up: Lichen sclerosus follows a chronic course and can recur over the years despite treatment.
02
Why is it critical from a surgical standpoint?
Diseased skin cannot be used as a graft. Repairs done with foreskin or penile skin become affected by the disease in this tissue and fail within a short time.
- For this reason, the preferred tissue is oral mucosa — it isn't affected by the disease. The most commonly missed cause of repeated failed repairs is skipping the diagnosis and repairing with a skin graft.
03
Treatment
- In the early stage, topical medication (ointments containing a potent corticosteroid) can slow the disease; it doesn't always make surgery unnecessary.
- If confined to the opening: meatoplasty with oral mucosa.
- If the channel is involved: the diseased segment is completely removed, the foundation is prepared with a mucosal graft, and the channel is built in a second session.
- Not used: penile skin and foreskin grafts.
04
Follow-up
Lichen sclerosus follows a chronic course and can recur over the years despite treatment. Regular check-ups should not be neglected.
Frequently asked questions
How is the diagnosis confirmed?
Through dermatological assessment and, when needed, a tissue sample (biopsy). This assessment must always be done in cases of recurring meatal stricture.
Why staged treatment?
Because the diseased tissue must be completely removed and the foundation prepared with healthy mucosa, the process is usually split into two stages, about 6 months apart.
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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.After SurgeryMeatal Stenosis TreatmentThe urinary opening has narrowed during healing. A thinning stream and straining are typical findings. The fix is simple in most cases, but follow-up is needed because, if neglected, it can put pressure on the bladder.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.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.
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