Two-stage repair with long channel technique for primary severe hypospadias.
OBJECTIVE
To introduce a 2-stage repair with long channel technique for primary severe hypospadias.


METHODS
Between March 2010 and November 2013, 16 children with primary severe hypospadias underwent 2-stage repair with long channel technique. The technique applied in the first stage was almost the same as Bracka 2-stage repair. The second stage was usually performed 6 months later. A small transverse skin incision, distal to the meatal opening and about 1 cm in length, was made. Dissection was carried out deep into the surface of corpora cavernosa and a plane between the subcutaneous tissue and corpora cavernosa was reached. A long channel between the subcutaneous tissue and corpora cavernosa was created from the para-meatus incision to the apex of glans. A rectangle, pedicle scrotal septal skin flap was elevated and tubularized into neourethra around a stenting tube. The neourethra was delivered through the subcutaneous channel and fixed at the apex of glans.


RESULTS
The mean operation time of the first and second stages was 65 and 55 minutes, respectively. The mean age at the first and second operation was 28 and 36 months, respectively. The mean follow-up was 10 months. No fistula, glans dehiscence, urethral stricture, and meatal stenosis were recorded. One scrotal surgical wound infection occurred after second stage and healed successfully with antibiotics treatment. The overall cosmetic and functional outcomes after second stage were excellent.


CONCLUSIONS
Two-stage repair with long channel technique was applicable for primary severe hypospadias, with excellent short-term outcomes.
Department of Pediatric Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Affiliated Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Tianyou
T
Yang
Department of Pediatric Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Qigen
Q
Xie
Department of Pediatric Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China; Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Affiliated Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Qifeng
Q
Liang
Department of Pediatric Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Yeqing
Y
Xu
Department of Pediatric Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. Electronic address: sucheng@mail.sysu.edu.cn.
Cheng
C
Su
D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D013521:Urologic Surgical Procedures, Male / Q000379:methods