title: Video presentation of the second stage of a two-stage repair for proximal hypospadias: a safe and reproducible technique.
abstract: OBJECTIVE
  The aims of proximal hypospadias repair are good cosmetic outcomes with low rates of complication, with a low number of operative exposures, before the age of genital difference realisation. Neo-urethral fistula and stenosis are well recognised complications; with international rates of 3.8-16% and 1.3-15.6% respectively. We present the key steps of the second of a two staged repair in video format.
  
  
  METHODS
  Video recording of the procedure performed on an 18-month-old with mid-penile hypospadias is presented. The steps are described; the importance of tension free tubularisation, layered urethral closure, suture technique, vascularised prepucal graft technique, optimal glanuloplasty, and penile shaft skin repair are highlighted.
  
  
  RESULTS
  The child was brought back to the day ward for catheter removal at 7 days; follow-up in clinic showed good postoperative appearance. This technique has been performed on 31 boys with a fistula rate and stenosis rate favourable to the literature.
  
  
  CONCLUSIONS
  We demonstrate a two-stage technique by video format for proximal hypospadias which is reproducible and gives results comparable to the literature.
authors.affiliation: Norfolk and Norwich University Hospital, Norwich, UK. Electronic address: c.m.smith@doctors.org.uk.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Smith
authors.affiliation: Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: Aaron
authors.initials: A
authors.lastname: Rooney
authors.affiliation: Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: Anand
authors.initials: A
authors.lastname: Upasani
authors.affiliation: Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: Azad B
authors.initials: AB
authors.lastname: Mathur
mesh_terms: D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation; D013536:Suture Techniques
keywords: Braka stage 2; Proximal hypospadias; Second-stage repair