Outcome of Ventrally Trans Positioned Total Preputial Flap for Staged Repair of Proximal Hypospadias

Document Type : Perspectives

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Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Abstract

Objectives: Our work seeks to evaluate the use of the ventrally trans-positioned total preputial flap [TPF] for staged proximal hypospadias correction.
Patients and Methods: An interventional prospective nonrandomized study included 20 participants who have proximal hypospadias and had a two-stage correction with TPF. The inclusion criteria were any uncircumcised children with proximal hypospadias [age was ranged from 6 months till 18 years]. Circumcised patients, recurrent cases and mid or distal shaft hypospadias were excluded from the study. Hypospadias objective scoring system utilized for post-operative analysis.
Results: The first stage operation's average patient age was 2.5 years [9 months–16 years]; and the typical follow-up period lasted 8 months. There was a proximal penile urethral meatus in 17 [85%] patients also penoscrotal in 2 [10%] and mid shaft in one case [5%] that converted to proximal shaft after release of chordee. After the second stage operation, seventeen patient [85%] had successful outcome and complications following surgery occurred in 3 [15%] patients with urethra-cutaneous fistula in one patient [5%], meatal stenosis one case [5%] and one case had persistent chordee [5%]. The results of the objective scoring evaluation for hypospadias were satisfactory in 95% of patients, with satisfactory both functional and cosmetic outcome.
Conclusion: With the 15% tolerable complexity rate, the ventrally trans-positioned total preputial flap [TPF] is a reliable procedure with acceptable success rate and low complications.

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