Can previously relocated penile skin be successfully used for salvage hypospadias repair?
Between 1986 and 1992, 39 boys underwent 44 pedicle flap urethroplasties as a salvage procedure using penile skin that had been relocated during prior hypospadias repair(s). All previous operations had resulted in a meatus in an unacceptable position. The salvage pedicle flap procedure used for these boys was either a Mathieu urethroplasty or an island flap repair. Of 28 patients who underwent salvage Mathieu urethroplasty 20 (71%) required no further surgery, 4 had strictures or fistulas repaired and 4 (14%) required further urethral reconstruction, including 1 island flap and 2 Mathieu operations. Of 16 boys who underwent salvage island flap procedures 7 (43%) required no further treatment, 4 had fistulas, 2 had had urethral strictures and 4 had a subcoronal meatus, of whom 3 underwent further urethral reconstruction, including 2 Mathieu and 1 Thiersch-Duplay operations. We defined overall success as ultimately having a functional urethra without persistent fistulas or strictures and a cosmetically acceptable glanular meatus. Excluding 2 patients who are awaiting fistula repair, 34 of 37 evaluable cases (92%) were successfully repaired. We conclude that relocated penile skin can be used successfully to base a pedicle flap for salvage hypospadias repair.
Hospital for Sick Children, Toronto, Ontario, Canada.
V R
VR
Jayanthi
G A
GA
McLorie
A E
AE
Khoury
B M
BM
Churchill
D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D010413:Penis / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D016038:Skin Transplantation; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*