[Treatment of proximal hypospadias: the onlay technique].
In 1987 Elder and Duckett published a modification of the Duckett technique for hypospadias repair, substituting the transverse preputial island flap for the onlay island. This modification preserves the urethral plate and has no circular anastomoses, the most common cause of fistulas and stenosis.


METHODS
We present our experience in 67 cases with hypospadias (60 with chordee). The meatus was in the superior third of the penis in 15 cases, in the middle third in 29, at the base of the penis in 11, and interscrotal in 12 patients. Preoperative hormonal substitution was administer in 12 patients, correction of the chordee was possible in 66 cases, the urethral plate was dissected in 18 cases, and the Nesbit procedure in 16 cases.


RESULTS
A good result was obtained in 59 cases a straight penis, meatus at the tip of the penis, good calibre of the urinary stream and a satisfactory esthetic result. Our rate of complication was of 12%, five fistulas, two partial deshicences of the preputioplasty and in one case a discrete chordee.


CONCLUSIONS
We believe this is an surgical technique for one stage procedure in severe cases of proximal hypospadias with chordee with a good functional and esthetic result and few complications.
Piró Biosca
C
C
Hospital Universitario "Vall d'Ebron", Barcelona.
Martín Osorio
J A
JA
Acosta Fariña
D
D
Chicaíza Marcillo
E
E
Ezzedine Ezzedine
M
M
D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000473:pathology / Q000601:surgery*; D007223:Infant; D008297:Male; D013524:Surgical Flaps; D013521:Urologic Surgical Procedures, Male / Q000379:methods