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Objective: To introduce an operative method of combining the complex of gelatin spongy and micromucosa from inner prepuce or urethral plate graft with the local flap in the treatment of scrotal hypospadias and penoscrotal hypospadias and to investigate its therapeutical effect., Methods: From April 2006 to December 2007, 8 cases of congenital hypospadias were treated, aging 8 months to 3 years. Three cases were scrotal hypospadias, the others were penoscrotal hypospadias. The length of penis was 2.5-4.5 cm. All cases were repaired with micro-mucosa which taken from inner prepuce or urethral plate, gelatin sponge and local flap. The size of the local flap was 2.5 cm x 1.0 cm-4.5 cm x 1.2 cm. Only one of the 8 cases underwent two-stage operation, and 7 cases underwent one-stage operation., Results: The operation time was (150 +/- 35) minutes. The length of repaired urethra was (3.38 +/- 0.79) cm. All flaps survived after operation. Eight cases were followed up for 2-24 months. All cases were successful without urethral fistula and urethral stricture postoperatively. A vertically oriented, slit neomeatus was gained after operation and satisfactory voiding function. The appearance of penis resembled the appearance after prepuce circumcision. All the patients have normal urination and erection. Superficial penile curvature occurred in one case after 12 months postoperatively., Conclusion: Gelatin sponge and micro-mucosa from inner prepuce or urethral plate graft combined with local flap can repair the scrotal hypospadias and penoscrotal hypospadias. The advantages are to decrease the utilization of local tissues, improve the appearance of glans and decrease the complication rates.

Unlabelled: OBJECTIVE To investigate the effect of vaginal reconstruction with autologous buccal micro-mucosa graft., Methods: From March 2007 and April 2008, 10 patients with absence of vagina were treated, aged 18-31 years (mean 26 years). Nine of them were congenital absence of vagina, and the remaining one was vaginal stenosis after vaginal reconstruction. They all exhibited normal secondary sexual characteristics, normal hormonal levels and 46, XX karyotype. Their abdominal ultrasonography revealed the normal ovaries and tubes but absence of the uterus or small rudimentary horns. However the one with vaginal stenosis had normal uterus. The buccal mucosa graft was minced into 0.5 mm in size and was transplanted to the cavity which was dissected between the bladder and the rectum., Results: The operation was performed successfully in all cases. The operative time was about 1-2 hours and operative blood loss was 80-100 mL. Postoperative complication occurred in only one case for vaginal bleeding. The patient recovered and the wound healed well after immediate management. The others healed primarily without any complications. All cases were followed up for 4-16 months. The depth of neovagina which was formed was 6-10 cm and the width was about two fingers. The lining was pink-colored and smooth, and was confirmed as nonkeratinizing squamous stratified mucosa by histopathological examination. The donor sites healed uneventfully with no change in mouth opening. The perineal area was not disturbed. Four patients were married and satisfied with their sexual life without pain and bleeding., Conclusion: Vaginal reconstruction with autologous buccal micro-mucosa graft is an easy, minimally invasive and useful method.