Pedicled preputial island flap for double functions in hypospadias surgery

Özet

Objective: To use the prepuce for double functions one as a second layer for the neourethra to decrease theincidence of urethrocutaneous fistula and the second as a skin covering for the ventral aspect of the penis.Material and methods: From January 2013 to December 2016, 37 cases of hypospadias with mild to moderate chordee were included in this study. The cases with ventral penile skin defect were managed by tubularized incised plate urethroplasty (TIPU) using pedicled preputial flap. Recurrent cases, cases with severechordee which necessitated division of the urethral plate, and cases with penoscrotal hypospadias wereexcluded from this study.Results: Thirty-seven cases of hypospadias aged 9-60 months with a mean age of 24.8 months were included in this study. Coronal (n= 9 cases; 24.3%), distal penile (n=11; 29.9%), and midpenile hypospadias (n=17; 45.9%) were detected in respective number of patients. Postoperative complications consisted of externalmeatal stenosis (n=2; 8.1%), and one case with urethrocutaneous fistula. Skin necrosis was not reported inthis study. Follow-up visits were performed at 1, 3 and 6 months which showed good cosmetic appearancethat was accepted by their parents.Conclusion: This technique was beneficial in decreasing the rate of skin necrosis, as it keeps the blood supply to the preputial skin intact, and decreases the incidence of urethrocutaneous fistula.