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. 2021 May;39(5):1613-1624.
doi: 10.1007/s00345-020-03324-7. Epub 2020 Jun 29.

Double-face preputial island flap revisited: is it a reliable one-stage repair for severe hypospadias?

Thomas Blanc  1 , Matthieu Peycelon  1 , Mohammed Siddiqui  1 , Cecile Muller  1 , Annabel Paye-Jaouen  1 , Alaa El-Ghoneimi  2
Affiliations

Double-face preputial island flap revisited: is it a reliable one-stage repair for severe hypospadias?

Thomas Blanc et al. World J Urol. 2021 May.

Abstract

Purpose: We have studied outcome of double-face preputial island flap (DFPIF) technique in severe types of hypospadias: penoscrotal, scrotal and perineal.

Methods: We have used DFPIF in 75 boys at a median age of 1.1 years (1.0-1.5). The meatus was penoscrotal, scrotal or perineal after de-gloving the penis. The inner face of the foreskin was used for urethroplasty and the outer face for ventral skin covering. Modifications were added: proximal anastomosis was protected by a spongioplasty; in case of urethral plate transection, we anastomosed on onlay proximal and distal segments of the flap (onlay-tube-onlay) and the tubularized part was sutured to corpus cavernosa. FU was scheduled at one month then every 3 months for a year then annually. At each consultation, the surgeon filled out a detailed cosmetic and functional sheet including flowmeter.

Results: Thirty-four patients had onlay preputial flap repair with urethral plate preservation. Forty-one had the onlay-tube-onlay technique. All children had a curvature, 19 had a significant residual curvature after dissection, corrected by dorsal plication (n = 9) and ventral lengthening (n = 10). Median FU was 4.2 years (2.7-6.5). 36 children (48%) had complications and needed redo surgery: 12 fistulas, 11 diverticula, 7 meatal stenosis, 3 strictures and 2 residual curvatures. All children but three voided within the normal limits for their age.

Conclusion: DFPIF remains a good option for a one-stage repair of severe hypospadias. After a median of 1.8 procedures, the final success rate was 96%. The healthy well-vascularized ventral skin allows safe redo surgery when needed.

Keywords: Curvature; Double face; Preputial flap; Proximal hypospadias; Single stage.

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References

    1. Castagnetti M, El-Ghoneimi A (2010) Surgical management of primary severe hypospadias in children: systematic 20-year review. J Urol 184(4):1469–1474 - DOI
    1. Long CJ, Canning DA (2016) Hypospadias: are we as good as we think when we correct proximal hypospadias? J Pediatr Urol 12(4):196.e1–5 - DOI
    1. Elder JS, Duckett JW, Snyder HM (1987) Onlay island flap in the repair of mid and distal penile hypospadias without chordee. J Urol 138(2):376–379 - DOI
    1. Snodgrass WT (2005) Snodgrass technique for hypospadias repair. BJU Int 95(4):683–693 - DOI
    1. Duckett JW (1981) The island flap technique for hypospadias repair. Urol Clin North Am 8(3):503–511 - PubMed

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