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. 2022 Sep 21:2022:6996933.
doi: 10.1155/2022/6996933. eCollection 2022.

Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett's Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study

Mohamed Shahin  1 , Mohamed Abdalrazek  2 , Mohamed Abdelmaboud  2 , Ibrahim Mahmoud Elsayaad  1 , Muhammad Abdelhafez Mahmoud  2 , Mahmoud Abdelhady Mousa  3 , Ahmed Elshamy  3 , Omar Alsamahy  4 , Mohamed Rehan  5 , Sayed Elhady  1 , Ibrahim Gamaan  2
Affiliations

Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett's Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study

Mohamed Shahin et al. Adv Urol. .

Abstract

Background: Proximal hypospadias, with significant curvature, is one of the most challenging anomalies. Great diversity and a large number of procedures described over the last 4 decades confirmed the fact that no single procedure has been universally accepted or successful. So, the aim of this study is to evaluate double-faced tubularized preputial flap (DFPF) versus transverse tubularized inner preputial flap (Duckett's procedure) as regards surgical outcomes, complications rate, and cosmetic results for repair of penoscrotal hypospadias with chordee. Patients and Methods. This was a prospective comparative study on 144 children with primary penoscrotal hypospadias with moderate or severe chordee, conducted at New Damietta and Assuit hospitals, Al-Azhar University, from March 2016 to March 2022. The patients were randomly divided into two equal groups; group A (n = 72) underwent DFPF, and group B (n = 72) underwent Duckett's procedure.

Results: No significant difference was identified as regards demographic data. The follow-up period ranged from 20 to 66 months (mean of 28 months after DFPF and 31 months after Duckett's repair), and the complication rate was 20.1% (29 of 144 children). There were statistically significant differences between the two groups as regards the urethral stricture, penile rotation, and total complication rate. HOSE score was adopted for assessment of surgical outcomes, urine stream, and cosmetic results.

Conclusions: The DFPF technique is feasible and reliable for one-stage repair of penoscrotal hypospadias with chordee and can be considered as a good option as it ensures better surgical and cosmetic outcomes with lower incidence of complications.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Steps of the double-faced preputial flap (DFPF) technique. (a) Penoscrotal hypospadias. (b) Preputial flap is tubularized over Nelaton's catheter. (c) Pedicle of the flap completely dissected off dorsal shaft skin and corpora down to the penopubic angle. The neo-urethral tube with still attached outer preputial layer of the flap is transposed to the ventral aspect of the penis. (d) Outer preputial layer of the flap is trimmed and sutured to the remaining dorsal shaft skin.
Figure 2
Figure 2
Steps of the transverse tubularized preputial island flap (Duckett's) technique. (a) Penoscrotal hypospadias. (b) Inner preputial flap is tubularized over Nelaton's catheter. (c) Neo-urethral tube is transposed to the ventral aspect of the penis with closure of skin. (d) Side view after repair was completed.
See this image and copyright information in PMC

References

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