Snodgrass hypospadias repair with ventral based dartos flap in combination with mucosal collars.
OBJECTIVE
In this study, we report our results of Snodgrass hypospadias repair in conjunction with use of ventral based vascularized dartos flaps. In all repairs, mucosal collars were created and incorporated into the repair to create a more normal appearing circumcised penis, as described by Firlit.


METHODS
Records of 60 patients with distal or mid-penil hypospadias who underwent standard Snodgrass repair were evaluated. During circumscribing incision mucosal collars were preserved and used to create a normal appearing circumcision line. A ventral based vascular dartos tissue was preserved as a flap and used as a second layer to cover the entire neourethra before glans closure.


RESULTS
All repairs were completed in 1 stage. Mean follow-up was 10.5 months (3-37 months). There were 5 (8.3%) cases of fistula and 6 (10%) cases of meatal stenosis. All patients with fistula formation had meatal stenosis. All patients, except for patients with fistula and/or metal stenosis, were voiding a straight stream and have a slit like meatus with cosmetically normal looking circumcised penis.


CONCLUSIONS
Ventral based flaps are easier to harvest and transpose to cover the neourethra. Combining repairs with mucosal collars enhances the cosmetic results and makes the ventral flap harvesting process easier.
Soygur
Tarkan
T
University of Ankara, School of Medicine, Department of Urology, Division of Pediatric Urology, Paris Caddesi, 35/17, Kavaklidere, Ankara, 06540, Turkey. soygur@medicine.ankara.edu.tr
Arikan
Nihat
N
Zumrutbas
Ali E
AE
Gulpinar
Omer
O
D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods*