'Batman excision' of ventral skin in hypospadias repair, clue to aesthetic repair (point of technique).
OBJECTIVE
In the hypospadiac penis the ventral skin is poorly developed, while dorsal skin is redundant. The classical Byars' flaps are a way to use the excess dorsal skin to cover the penile shaft. The appearance after Byars' flaps however is not natural. We use a more natural looking skin allocation with superior aesthetic results.


METHODS
The clue in this reconstruction is an inverted triangle shaped excision of ventral skin expanding over the edges of the hooded prepuce (which makes it look like Batman). After excision of the ventral skin it is possible to close the penile skin in the midline, thus mimicking the natural raphe. In case of preputial reconstruction the excised ventral skin makes the prepuce look more natural.


CONCLUSIONS
The trend of further refining aesthetic appearance of the hypospadiac penis often neglects the penile skin reconstruction. A technique is presented by which the total penile appearances after surgery ameliorates due to better skin reconstruction.
Hoebeke
P B
PB
Department of Urology, Pediatric Urology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium. piet.hoebeke@rug.ac.be
De Kuyper
P
P
Van Laecke
E
E
D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques