Buccal Mucosa Neourethras Grow Proportionally After Puberty

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To the Editor:
We would like to comment on the article “Can We Preserve the Urethral Plate in Proximal Hypospadias Repair?” by Acimi S and Acimi MA.1 Surgical technique in hypospadias, especially proximal cases, is controversial. Many different techniques are available, each with advantages and disadvantages. The subject is complex, and the relative frequency of complications is not sufficient to define a technique as superior because the severity of the complications has also to be considered, as well as the technique needed to correct the problems. Moreover, the extension of follow-up must be considered because some complications typically present long term. Recurrent curvature, for example, is mostly diagnosed after puberty. Concerning the authors' worries about the possibility of inadequate growth of the neourethra after buccal graft–staged urethroplasty, our group has published an article proving that this problem does not occur. Buccal mucosa grafts diameter and length grow proportionally to the phallus after puberty.2
Our compliments to the authors for their great article.
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