Abstract Aim: To evaluate the long‐term effects on hypospadias repair with cultured autologous urothelial cells. Methods: From 2000 to 2002, six patients with scrotal or perineal hypospadias and pronounced
chordee were treated surgically with cultured autologous urothelial cell transplants. All patients were evaluated at 6–8 years postoperatively, that is, in the prepubertal period. The outcome was assessed with respect to cosmetic appearance, voiding function, urinary flow, artificial
erection, urethroscopy and biopsies. Results: Median follow‐up time was 7.25 years. Up to date, all patients present with a good cosmetic appearance. One of the boys prefers a sitting voiding position. Urinary flow curves are bell‐shaped in all but one. All
have straight erections, urethroscopy reveals an even, non‐hair‐bearing surface on the transplanted side and 2/6 present with urothelial cells in biopsies. Limitations of this follow‐up study include a small group of patients and lack of controls. However, patients with
severe hypospadias have high complication rates, and our results are equal or better than expected for the phenotype. Conclusion: Tissue engineering for severe hypospadias repair can be performed in a safe manner. The method is feasible for treatment of a selected group of
hypospadias, where pronounced chordee and shortage of preputial and penile skin complicates the creation of a neourethra.