Dorsal dartos flap in Snodgrass hypospadias repair: how to use it?
OBJECTIVE
To introduce new technique for covering neourethra with dorsal dartos subcutaneous tissue in Snodgrass hypospadias repair.


METHODS
The study included 26 patients with primary hypospadias, aged 2-22 years (average 7.86), operated from June 2002 to August 2006. Of the patients, 21 had distal, 3 midshaft and 2 penoscrotal hypospadias. The standard technique of tubularized incised plate (TIP) with double-layer covering of the neourethra by subcutaneous tissue was used in all cases of reconstruction. The mean follow-up period was 4.5 months (range 3-12 months).


RESULTS
Successful result of a normal-looking penis without fistula was achieved in all patients. One patient had meatal stenosis (3.84%) at the early postoperative period which was corrected by urethral dilatation of the external meatus at an interval of up to 2 months postoperatively.


CONCLUSIONS
Our technique represents a reasonable option for utilizing dorsal dartos subcutaneous tissue in TIP urethroplasty. The neourethra is covered symmetrically with a double layer of well-vascularized tissue and the penis is kept without rotation. Redundancy of the flap and its excellent vascularization depend on the harvesting technique. Further follow-up and a larger number of patients are needed before a final conclusion can be made.
Mustafa
Mahmoud
M
Department of Urology, Medicana Hospital, Istanbul and Osmaniye State Hospital, Osmaniye, Turkey. dr_mahmoud68@yahoo.com
Wadie
Bassem S
BS
Abol-Enein
Hassan
H