title: A favorable experience with rotational flap techniques for fashioning the Firlit preputial collar.
abstract: OBJECTIVE
  The Firlit collar technique for the approximation of the divergent inner leaf of the prepuce in operations to repair hypospadias and its variants are generally easily conceptualized and executed. However, in some cases the divergence is so great at the level of the corona that a simple approximation cannot be performed. Therefore, 2 techniques are described that facilitate completion of the Firlit collar in these instances.
  
  
  METHODS
  A total of 101 boys 6 to 101 months old (mean 18.9) underwent formation of a Firlit collar between July 2003 and July 2004. Among the patients 69 had coronal or glanular hypospadias, 17 had a penile or a more proximal meatus and 15 had only a hooded prepuce. In 5 patients the divergence of the inner leaf of the prepuce precluded a simple midline approximation of the 2 halves. Two techniques of forming rotational flaps of the inner leaf were used to complete construction of the Firlit preputial collar.
  
  
  RESULTS
  The techniques were used as described in 5 repairs, with excellent cosmetic results.
  
  
  CONCLUSIONS
  Two rotational flap techniques for the repair of the widely divergent inner leaf of the prepuce associated with hypospadias and its variants are described and recommended for their simplicity and uniformly good results.
authors.affiliation: Department of Urology, University of Arkansas College of Medicine and Arkansas Children's Hospital, Little Rock, 72205, USA. redmanjohnf@uams.edu
authors.forename: John F
authors.initials: JF
authors.lastname: Redman
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D010413:Penis / Q000601:surgery*; D013524:Surgical Flaps; D013521:Urologic Surgical Procedures, Male / Q000379:methods