{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:43:38Z","timestamp":1755798218136,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82273014"],"award-info":[{"award-number":["82273014"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010248","name":"Zhejiang Province Public Welfare Technology Application Research Project","doi-asserted-by":"crossref","award":["LGD22H050002"],"award-info":[{"award-number":["LGD22H050002"]}],"id":[{"id":"10.13039\/501100010248","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["World Jnl Ped Surgery"],"accepted":{"date-parts":[[2025,2,6]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to evaluate the medium and long-term outcomes of tunneled labial mucosa tube graft urethroplasty in the treatment of primary severe hypospadias and failed hypospadias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed the medical records of the patients who underwent tunneled labial mucosa tube graft urethroplasty at a single center between 2007 and 2020. Data collected included patient demographic, operative and post-operative characteristics. The surgical procedure was performed in two stages. Binary logistic regression model was used to identify risk factors for postoperative complication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 82 patients who were followed for at least 12 months were included in this study. Among these, 56 patients received primary repair, while 26 had previously undergone failed reconstruction. The mean age at surgery was 5.0 years. Postoperative urinary fistula occurred in 36 patients, with 24 requiring surgical repair and 12 resolving spontaneously. Urethral stricture developed in 26 patients, with 20 undergoing surgical intervention and 6 managed with urethral dilation. Preoperative surgical history was identified as an independent risk factor for postoperative complications (<jats:italic>p<\/jats:italic>=0.015).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although the complication rate associated with tunneled labial mucosa tube graft urethroplasty is relatively high compared with other techniques, it remains a viable option for patients with insufficient replacement materials, particularly for primary severe hypospadias. For cases of failed hypospadias repair, this procedure should be considered selectively based on patient-specific factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/wjps-2024-000976","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T19:05:58Z","timestamp":1741115158000},"page":"e000976","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Medium- and long-term outcomes of tunneled labial mucosa tube grafts for the repair of primary severe hypospadias and failed hypospadias"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9670-4298","authenticated-orcid":false,"given":"Hengyou","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangjie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dehua","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Ru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daxing","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"2025081810101011000_8.1.e000976.1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1007\/s11934-013-0334-9","article-title":"Use of buccal mucosa in hypospadias repair","volume":"14","author":"Cruz-Diaz","year":"2013","journal-title":"Curr Urol Rep"},{"key":"2025081810101011000_8.1.e000976.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.094"},{"key":"2025081810101011000_8.1.e000976.3","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.urology.2019.12.027","article-title":"Bracka\u2019s Method of Proximal Hypospadias Repair: Preputial Skin or Buccal Mucosa?","volume":"138","author":"Manasherova","year":"2020","journal-title":"Urology"},{"key":"2025081810101011000_8.1.e000976.4","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1016\/j.juro.2014.10.093","article-title":"Tunneled buccal mucosa tube grafts for repair of proximal hypospadias","volume":"193","author":"Fine","year":"2015","journal-title":"J Urol"},{"key":"2025081810101011000_8.1.e000976.5","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ucl.2016.08.014","article-title":"Management of Urethral Strictures After Hypospadias Repair","volume":"44","author":"Snodgrass","year":"2017","journal-title":"Urol Clin North Am"},{"key":"2025081810101011000_8.1.e000976.6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1464-410X.1995.tb07815.x","article-title":"Hypospadias repair: the two-stage alternative","volume":"76 Suppl 3","author":"Bracka","year":"1995","journal-title":"Br J Urol"},{"key":"2025081810101011000_8.1.e000976.7","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ajur.2016.05.006","article-title":"History and evolution of the use of oral mucosa for urethral reconstruction","volume":"4","author":"Barbagli","year":"2017","journal-title":"Asian J Urol"},{"key":"2025081810101011000_8.1.e000976.8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.eururo.2010.01.012","article-title":"Morbidity of oral mucosa graft harvesting from a single cheek","volume":"58","author":"Barbagli","year":"2010","journal-title":"Eur Urol"},{"key":"2025081810101011000_8.1.e000976.9","first-page":"373","article-title":"Application of lower lip mncosa for hypospadias repair","volume":"31","author":"Tang","year":"2010","journal-title":"Chin J Pediatr Surg"},{"key":"2025081810101011000_8.1.e000976.10","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.urology.2020.07.065","article-title":"Buccal Mucosa Tube Graft for Failed Hypospadias Repair: Worth it or Not?","volume":"146","author":"Kim","year":"2020","journal-title":"Urology"},{"key":"2025081810101011000_8.1.e000976.11","first-page":"18","article-title":"Risk factors for short-term complications of hypospadias repair with transverse preputial island flap urethroplasty","volume":"21","author":"Fang","year":"2022","journal-title":"J Clin Ped Sur"},{"key":"2025081810101011000_8.1.e000976.12","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jpurol.2016.11.012","article-title":"Re-operative urethroplasty after failed hypospadias repair: how prior surgery impacts risk for additional complications","volume":"13","author":"Snodgrass","year":"2017","journal-title":"J Pediatr Urol"},{"key":"2025081810101011000_8.1.e000976.13","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1097\/01.ju.0000142451.78966.fb","article-title":"Long-term followup of buccal mucosa onlay graft for hypospadias repair: analysis of complications","volume":"172","author":"Fichtner","year":"2004","journal-title":"J Urol"},{"key":"2025081810101011000_8.1.e000976.14","first-page":"745","article-title":"The application of buccal Mucosa In urethral reconstruction","volume":"29","author":"Li","year":"2014","journal-title":"J Clin Urology"},{"key":"2025081810101011000_8.1.e000976.15","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.juro.2010.10.047","article-title":"Critical Outcome Analysis of Staged Buccal Mucosa Graft Urethroplasty for Prior Failed Hypospadias Repair in Children","volume":"185","author":"Leslie","year":"2011","journal-title":"Journal of Urology"},{"key":"2025081810101011000_8.1.e000976.16","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1007\/s11255-018-1962-2","article-title":"Management of failed hypospadias: choosing the right method and achieving optimal results","volume":"50","author":"Wu","year":"2018","journal-title":"Int Urol Nephrol"},{"key":"2025081810101011000_8.1.e000976.17","first-page":"187","article-title":"Modified Koyanagi technique for one\u2043stage repair of severe hypospadias:short\u2043term efficacies","volume":"36","author":"Kang","year":"2015","journal-title":"Chin J Pediatr Surg"},{"key":"2025081810101011000_8.1.e000976.18","first-page":"854","article-title":"Surgical advances of severe hypospadias","volume":"43","author":"Fang","year":"2022","journal-title":"Chin J Pediatr Surg"},{"key":"2025081810101011000_8.1.e000976.19","first-page":"685","article-title":"A multicenter study of treatment status and short\u2043term prognosis of proximal hypospadias","volume":"43","author":"Fang","year":"2022","journal-title":"Chin J Pediatr Surg"},{"key":"2025081810101011000_8.1.e000976.20","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.juro.2015.04.105","article-title":"Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience","volume":"194","author":"McNamara","year":"2015","journal-title":"J Urol"},{"key":"2025081810101011000_8.1.e000976.21","doi-asserted-by":"crossref","DOI":"10.1136\/wjps-2023-000599","article-title":"Predictors of surgical complications in boys with hypospadias: data from an internationa registry","volume":"6","author":"Scougall","year":"2023","journal-title":"World J Pediatr Surg"},{"key":"2025081810101011000_8.1.e000976.22","doi-asserted-by":"crossref","DOI":"10.1136\/wjps-2023-000659","article-title":"Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures","volume":"7","author":"Borkar","year":"2024","journal-title":"World J Pediatr Surg"}],"container-title":["World Journal of Pediatric 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