Para-meatus skin incision with long channel technique for midshaft hypospadias repair without penile curvature - Abstract

OBJECTIVE:To report a new surgical technique for midshaft hypospadias repair without penile curvature.

METHODS:From September 2007 to October 2010, 21 patients, aged 13 months to 8.9 years, underwent single-stage hypospadias repair by 1 surgeon. The skin incision was created around the meatus, and a long channel beneath the urethral plate was created through the incision to the apex of the glans. The inner preputial flaps were tubularized into a neourethra, which was then transposed to the ventral channel through a ventrolateral tunnel beneath Buck's fascia. Most of the neourethra was covered by the intact soft tissue of the distal ventral penis. The proximal portion of the neourethra was covered by Buck's and dartos fascia around the skin incision, and the skin incision was closed longitudinally. The length of the urethral defect and channel and the postoperative complications were collected and analyzed.

RESULTS:A total of 21 patients underwent single-staged hypospadias repair. The average length of the channel was 30 mm (range 25-35). The average length of the neourethra was 35 mm (range 30 to 40). The mean operative time was 60 minutes (range 50-70). The mean hospital stay was 12 days (range 10-14). With an average follow-up of 20 months (range 6-37), no postoperative complication was detected.

CONCLUSION: This technique provides excellent short-term results for midshaft hypospadias without penile curvature and is a safe and simple solution.

Written by:
Su C, Yang T, Zhang Z, Xu Y, Liang Q. Are you the author?
Department of Pediatric Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Reference: Urology. 2012 May;79(5):1143-8.
doi: 10.1016/j.urology.2011.11.034

PubMed Abstract
PMID: 22305761 Pediatric Urology Section