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El-Ghoneimi et al. Plast Aesthet Res 2022;9:39 Plastic and
DOI: 10.20517/2347-9264.2021.101
Aesthetic Research

Original Article Open Access

Tunneled tubularized bladder mucosal graft for long
urethral reconstruction: is it a reliable option in

selected complex cases in children and
adolescents?

1,2
1,2
1,2
1,2
Alaa El-Ghoneimi , Amane-Allah Lachkar , Pauline Lopez , Annabel Paye-Jaouen , Matthieu
Peycelon 1,2
1
Department of Pediatric Surgery and Urology, University Hospital Robert-Debré, APHP, Université Paris Cité, Paris 75019,
France.
2
National Reference Center for Rare Urinary Tract Malformations (MARVU), Paris 75019, France.
Correspondence to: Prof. Alaa El-Ghoneimi, Department of Pediatric Surgery and Urology, University Hospital Robert-Debré,
APHP, Université Paris Cité, 48 Boulevard Sérurier, Paris 75019, France. E-mail: alaa.elghoneimi@aphp.fr
How to cite this article: El-Ghoneimi A, Lachkar AA, Lopez P, Paye-Jaouen A, Peycelon M. Tunneled tubularized bladder mucosal
graft for long urethral reconstruction: is it a reliable option in selected complex cases in children and adolescents? Plast Aesthet
Res 2022;9:39. https://dx.doi.org/10.20517/2347-9264.2021.101

Received: 12 Sep 2021 First Decision: 22 Nov 2021 Revised: 28 Dec 2022 Accepted: 25 Jan 2022 Published: 1 Jun 2022
Academic Editor: Stan Monstrey Copy Editor: Tiantian Shi Production Editor: Tiantian Shi

Abstract
Aim: We analyzed the use of tubularized tunneled bladder mucosa graft (TBMG) and its application as a salvage
procedure or as primary surgery for long urethroplasty in children and adolescents. Specific attention was given to
a new method to harvest a long bladder mucosa graft through a minimal detrusotomy.

Methods: We analyzed the files of 10 patients who underwent TBMG urethroplasty at median age of 105 months
(range 20-195 months). The indications were perineal hypospadias cripple in two, masculinizing genitoplasty for
ovotesticular Ovotesticular Disorder of Sex Development (DSD) in two, perineal hypospadias in four, duplicated
urethra in one, and complications of circumcision in one. Staged reconstruction was performed in all patients. The
first stage was removal of all fibrous tissues and efficient treatment of curvature and skin coverage. After a minimal
delay of one year, a free bladder mucosa graft was harvested through a minimal detrusotomy and tubularized.
Tunneling of the graft was proceeded from the perineal urethrostomy to the glans.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
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