[Repair of hypospadias using scrotal septum vascular pedicle flap with two wing-like split-thickness skin graft].
OBJECTIVE
To investigate the effect of scrotal septum vascular pedicle flap with two wing-like split-thickness skin graft in reconstructing urethra in patients with hypospadias and in reducing the complications.


METHODS
From January 2007 to March 2008, 30 cases of hypospadias were treated, with a median age of 10 years (2-20 years). There were 13 cases of proximal shaft type, 12 cases of penoscrotal type and 5 cases of scrotal type. There were 8 cases with operation history. The flap size ranged from 4.0 cm x 0.8 cm to 9.0 cm x 1.0 cm and 5 mm with two wing-like split-thickness skin graft. When the downward curvature corrected, length of the flap could be determined by the length of the urethra that needed to be reconstructed.


RESULTS
All flaps survived. The incision healed by first intention in all patients except one whose incision healed after change dressing because of frequent erection. Incision at donor site healed well. Eighteen patients were followed up for 6-12 months, including 8 with second operation history. The reconstructed urethras were unobstructed and no urethrostenosis or urinary fistula happened.


CONCLUSIONS
This is an improved technique of the scrotal septum flap in urethra reconstruction. It takes advantages of both flap and split-thickness skin graft in reconstructing urethra and avoids the disadvantages of a single tissue. It is a good choice for treating hypospadias whose urinary meatus locates neighborly to penoscrotal junctional zone.
Department of Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100144, PR China.
Chenwang
C
Duan
Xunlei
X
Huang
Bin
B
Chen
Qiang
Q
Li
Wen
W
Chen
Senkai
S
Li
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D012611:Scrotum / Q000637:transplantation*; D016038:Skin Transplantation; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery; D055815:Young Adult