title: Staged proximal hypospadias repair: Modified thiersch duplay with midline incision in urethral plate followed by Mathieu urethroplasty.
abstract: OBJECTIVE
  Functional results, complications, cosmesis, operating time, and hospital stay were analyzed after staged urethroplasty for proximal hypospadias.
  
  
  METHODS
  Seventeen consecutive boys, mean age 17.7 +/- 1.6 months underwent a staged urethroplasty in the past 5 years. Urethral plate was tubularized and proximal hypospadias converted to distal. Hooded dorsal prepuce was buttonholed and transposed ventrally to cover the neo-urethra. Subsequently, a parameatal based flip flap urethroplasty completed the urethral reconstruction at mean age of 26.7 +/- 4.1 months.
  
  
  RESULTS
  Mean follow-up time was 2.8 +/- 1.7 years. Eighty-eight percent of boys who are now toilet trained and standing to void have a good caliber straight single stream of urine in a forward direction. Urethrocutaneous fistula was seen in 1 child (6%), and a simple fistulectomy with double layered closure was successful at first attempt of fistula closure. Cosmetic appearance of a natural vertical slit glanular meatus situated at normal position on the glans was achieved in all patients. Total mean operating time was 193.5 +/- 42.9 minutes and total mean duration of hospital stay was 3.4 +/- 0.6 days.
  
  
  CONCLUSIONS
  Staged urethroplasty for proximal hypospadias results in a normal penis with good function, minimal complications, and excellent cosmesis.
authors.affiliation: Department of Pediatric Surgery, St George's Health Care NHS Trust, London, England.
authors.forename: M
authors.initials: M
authors.lastname: Samuel
authors.forename: S
authors.initials: S
authors.lastname: Capps
mesh_terms: D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D010413:Penis / Q000601:surgery; D024162:Second-Look Surgery; D014521:Urethra / Q000601:surgery*; D014554:Urination