Meatal based hypospadias repair with the use of a dorsal subcutaneous flap to prevent urethrocutaneous fistula.
A technique using a dorsal dartos subcutaneous flap to wrap the neourethra after hypospadias repair is described. This method was used in a series of 204 meatal based repairs. Catheter drainage or diversion was not performed in any nontoilet trained child. The procedure was done on an ambulatory or 1-night hospitalization basis. No patient had a urethrocutaneous fistula. The additional covering of the neourethra with the dorsal subcutaneous flap appears to be excellent for avoiding the development of urethrocutaneous fistulas in patients with distal hypospadias.
Retik
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AB
Division of Urology, Children's Hospital, Boston, Massachusetts.
Mandell
J
J
Bauer
S B
SB
Atala
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000209:etiology / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods*; D014522:Urethral Diseases / Q000209:etiology / Q000517:prevention & control*; D014548:Urinary Fistula / Q000209:etiology / Q000517:prevention & control*