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AbstractPurposeSurgical management for the severe proximal hypospadias remains controversial and it might be challenging. In this study,we evaluated the surgical outcome of patients with proximal hypospadias managed by two staged repair with dorsal prepucial flaps.Patients and MethodsForty one boys with proximal hypospadias are enrolled between January 2006 and September 2016. The location of the urethral meatus was at the penoscrotal junction (PSH), at the scrotum (SH) or at the perineum (PRH). First stage; chordee was released and the prepucial flaps were constructed. Second stage; urethroplasty was performed according to Thiersch-Duplay principle. We assessed postoperative complication rates and utilized Hypospadias Objective Penile Evaluation (HOPE) scoring to evaluate the cosmetic outcome.ResultsThere are a total of 41 boys (31 PSH(%76), 3 SH(%7) and 7 PRH(%17). The mean age at first operation was 15±5,3 months. The mean interval between the stages of the surgical procedures was 10.1±4.,9months.Sixteen patients had various enzyme deficiency or dysgenesis. In two patients, diverticulum is developed after the repair. stenosis has encountered in 10 patients and fistula in 5. Two patients had dehiscence at glanular level. Relation did not demonstrated between the severity of hypospadias and development of fistula, stricture and diverticulum (p gt;0,05). HOPE scores; 9,4 for the position of the meatus, 5,8 for shape of the meatus, 7,2 for shape of the glans penis, 9,3 for penile torsion and 9,8 penile curvature. Conclusion Incorporating the dorsal prepucial skin flaps in staged procedures has both satisfactory cosmetic and functional success rates. |
