Tubularized preputial free graft one-stage repair for proximal hypospadias

Abstract

Background: One of the most frequent urogenital malformations in newborn boys is hypospadias. After undescended testis, in boys, it is the second most popular congenital abnormality. There are different one-stage surgical procedures used to repair proximal hypospadias, each has its own advantages and outcome. One of them is tubularized preputial free graft, which is first tried by the urologist team of Horton and Devine who used full thickness preputial grafts tubularized in a single-stage operation. Aim: The aim of this article is to assess the outcome of a one-stage tubularized preputial free graft. Materials and Methods: The present case series study provides a prospective analysis of 88 proximal hypospadiac boys operated on primarily over more than 5.5 years (from March 2014 to September 2019) using preputial skin as a tubularized free graft in one stage. Ethical approval for this review was obtained. Results: The present study includes 88 boys with hypospadias with mean age 20.6 months (ranging from 5 months to 7.5 years). The proximal hypospadias represents 33 (37.5%), penoscrotal 51 (58.0%), and scrotal 4 (4.5%) boys. Thirty-three boys out of 88 are under 12 years, 29 are between 12 and 24 years, and 26 above 24 years. The postoperative complications reported are fistula which occurs in 9 (10.3%), glans dehiscence in 3 (3.4%), meatal stenosis in 3 (3.4%), and diverticulum in 2 (2.3%), and numbers of complications with respect to age groups were six complications under 12 years, two complications between 12 and 24 years, and nine complications above 24 years. Conclusion: One-stage correction using a tubularized preputial free graft is an appropriate choice for repairing proximal hypospadias with chordee when compared with other widely used procedures for proximal cases.

Keywords

• one-stage hypospadias repair
• proximal hypospadias
• tubularized preputial free graft