{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:27:51Z","timestamp":1786343271816,"version":"build-2736575974"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Long-segment urethral stricture represents a major and challenging complication after multiple failed hypospadias repairs. In pediatric and adolescent patients, reconstructive strategies for these complex cases remain non-standardized, and clinical evidence is limited. Oral mucosa graft urethroplasty is widely used for long and complex adult urethral strictures because of its favorable tissue characteristics. However, its role in pediatric reconstructive urology, particularly in complex post-hypospadias strictures associated with lichen sclerosus (LS), remains rarely reported. We report the case of a 15-year-old patient with severe recurrent anterior urethral stricture after multiple previous hypospadias repairs, complicated by repeated episodes of urinary retention requiring suprapubic catheterization. Histological examination of a urethral biopsy confirmed lichen sclerosus. A single-stage dorsal inlay labial mucosa graft urethroplasty was performed according to the Asopa technique. Intraoperatively, a long-segment anterior urethral stricture extending to the peno-bulbar junction was confirmed. Given the preserved urethral plate width of approximately 2\u2005cm, a dorsal inlay approach was considered feasible. A 7\u2009\u00d7\u20092\u2005cm labial mucosa graft was harvested and quilted to the corporal bed, and the urethra was reconstructed over a 14 Ch Foley catheter with protective dartos flap coverage. The postoperative course was uneventful. At 18-month follow-up, the patient reported satisfactory voiding, no urinary tract infections, no filiform urinary stream, and no clinical evidence of recurrence. This case suggests that dorsal inlay labial mucosa graft urethroplasty may represent a feasible single-stage option in selected adolescents with complex post-hypospadias anterior urethral strictures, particularly when genital skin is unsuitable. Further pediatric experience and longer follow-up are needed to better define indications, durability, and functional outcomes.<\/jats:p>","DOI":"10.3389\/fped.2026.1918653","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:30:17Z","timestamp":1786339817000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Dorsal inlay labial mucosa graft urethroplasty for pediatric and adolescent long-segment urethral stricture after failed hypospadias repair"],"prefix":"10.3389","volume":"14","author":[{"given":"Ilaria","family":"Buconi","sequence":"first","affiliation":[{"name":"Andrological Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Spagnol","sequence":"additional","affiliation":[{"name":"Andrological Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Crescentini","sequence":"additional","affiliation":[{"name":"Andrological Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Rollo","sequence":"additional","affiliation":[{"name":"Andrological Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Corbi","sequence":"additional","affiliation":[{"name":"Andrological Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Silveri","sequence":"additional","affiliation":[{"name":"Andrological Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/j.eururo.2006.01.027","article-title":"Failed hypospadias repair presenting in adults","volume":"49","author":"Barbagli","year":"2006","journal-title":"Eur Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fped.2019.00005","article-title":"Anterior urethral strictures in children: disease etiology and comparative effectiveness of endoscopic treatment vs open surgical reconstruction","volume":"7","author":"Vetterlein","year":"2019","journal-title":"Front Pediatr"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1111\/j.1464-410X.2004.04860","article-title":"Buccal mucosal urethroplasty: is it the new gold standard?","volume":"93","author":"Bhargava","year":"2004","journal-title":"BJU Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1016\/s0090-4295(01)01377-2","article-title":"Dorsal free graft urethroplasty for urethral stricture by ventral sagittal urethrotomy approach","volume":"58","author":"Asopa","year":"2001","journal-title":"Urology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3978\/j.issn.2223-4683.2015.01.05","article-title":"Dorsal inlay buccal mucosal graft (asopa) urethroplasty for anterior urethral stricture","volume":"4","author":"Marshall","year":"2015","journal-title":"Transl Androl Urol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"555.e1","DOI":"10.1016\/j.jpurol.2018.07.008","article-title":"Penile fasciocutaneous flap urethroplasty for the reconstruction of pediatric long anterior urethral stricture","volume":"14","author":"Aldaqadossi","year":"2018","journal-title":"J Pediatr Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"289.e1","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":"B8","doi-asserted-by":"publisher","first-page":"579364","DOI":"10.3389\/fped.2020.579364","article-title":"Complications following primary repair of non-proximal hypospadias in children: a systematic review and meta-analysis","volume":"8","author":"Wu","year":"2020","journal-title":"Front Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1097\/01.ju.0000169422.46721.d7","article-title":"Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique?","volume":"174","author":"Barbagli","year":"2005","journal-title":"J Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.eururo.2008.06.002","article-title":"Dorsal buccal mucosal graft urethroplasty for anterior urethral stricture by asopa technique","volume":"56","author":"Pisapati","year":"2009","journal-title":"Eur Urol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1007\/s11255-020-02767-6","article-title":"Novel use of asopa technique for penile urethrocutaneous fistula repair","volume":"53","author":"Shaw","year":"2021","journal-title":"Int Urol Nephrol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/j.eururo.2008.07.046","article-title":"Lichen sclerosus of the male genitalia and urethra: surgical options and results in a multicenter international experience with 215 patients","volume":"55","author":"Kulkarni","year":"2009","journal-title":"Eur Urol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1007\/s00345-019-02871-y","article-title":"A critical outcome analysis of asopa single-stage dorsal inlay substitution urethroplasty for penile urethral stricture","volume":"38","author":"Zumstein","year":"2020","journal-title":"World J Urol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"719","DOI":"10.4103\/aja20236","article-title":"A comparative study of two single-stage oral mucosal substitution urethroplasty (kulkarni and asopa) in the surgical treatments of lichen sclerosus urethral strictures","volume":"25","author":"Wan","year":"2023","journal-title":"Asian J Androl"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1918653\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:30:27Z","timestamp":1786339827000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1918653\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":14,"alternative-id":["10.3389\/fped.2026.1918653"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1918653","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]},"article-number":"1918653"}}