title: Evaluation of Onlay Island Flap Technique in Shallow Urethral Plate Hypospadiasis.
abstract: BACKGROUND
  Hypospadias is one of the most common congenital genital anomalies in males that necessitates to be operated early in infancy (when 6 to 9 months old). On the other hand, hypospadias is a challenging field of pediatric urology with multiple reconstruction techniques. A perfect hypospadias repair is supposed to return urethral continuity with sufficient caliber, eradicate phallus curvature, and supply an acceptable appearance with low complications.
  
  
  OBJECTIVE
  This study aimed to evaluate the outcomes of using onlay island flap technique in the repair of hypospadias with shallow urethral plate.
  
  
  METHODS
  In this prospective study within June 2012 to December 2013, we performed onlay island flap procedure to repair hypospadias with shallow urethral plate measuring less than 6 millimeter. This technique was selected for all types of hypospadiasis except subcoronal type. Nesbit's dorsal plication procedure was established for chordee. In cases with very small glans, urethroplasty was performed without glansplasty.
  
  
  RESULTS
  Twenty three patients with mean age of 30 (range 10 - 60) months underwent onlay island flap repair; all had a shallow urethral plate < 6 mm, 3 had a very small glans, and 18 had chordee. Meatus was located in distal shaft in 5 cases, mid shaft in 8, proximal in 6 and penoscrotal type in 4 patients. Chordee was corrected with Nesbit's dorsal plication in 16 cases. Complications were: meatal stenosis in 2 cases and urethrocutaneous fistula in 2 patients, all of which were repaired surgically. Mean follow up time was 13 (3 - 20) months. All cases that had glansplasty have excellent esthetic appearance.
  
  
  CONCLUSIONS
  This technique offers acceptable results regarding meatal stenosis, urethrocutaneous fistula and esthetic outcome.
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Leily
authors: L
authors: Mohajerzadeh
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Alireza
authors: A
authors: Mirshemirani
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Mohsen
authors: M
authors: Rouzrokh
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Naser
authors: N
authors: Sadeghian
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Ahmad
authors: A
authors: Khaleghnejad-Tabari
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Alireza
authors: A
authors: Mahdavi
authors: Pediatric Sugery Department, Mofid Children's Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Sareh
authors: S
authors: Poorhasan
keywords: Hypospadias; Onlay Island Flap; Urethroplasty