title: Midshaft hypospadias.
abstract: The key to successful hypospadias surgery is minimal tissue handling, tension-free reconstruction, the use of well-vascularized tissue, and knowledge of which repairs are indicated. Preservation of the urethral plate along with an onlay graft has a low complication rate and should be attempted for midshaft hypospadias repair. Although tubularized pedicle flaps increase the risk of complications such as urethral strictures, urethral diverticula, and fistulas, they provide a good alternative in the presence of a poorly developed urethral plate. For correction of the penile curvature, we recommend ventral lengthening procedures in cases where simple dorsal plication will result in shortening of an already compromised penile length. Using these principles, excellent cosmetic and functional results can be expected for treatment of midshaft hypospadias.
authors.affiliation: Division of Urology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, M5G1X8, Canada. jyotiupadhyay@hotmail.com
authors.forename: Jyoti
authors.initials: J
authors.lastname: Upadhyay
authors.forename: Bijan
authors.initials: B
authors.lastname: Shekarriz
authors.forename: Antoine E
authors.initials: AE
authors.lastname: Khoury
mesh_terms: D002404:Catheterization; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D009779:Occlusive Dressings; D010413:Penis / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods*