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11–14 APRIL, 2018, HELSINKI, FINLAND
MATERIAL AND METHODS
In the period between 2014 and 2017, 180 patients with all types of hypospadias underwent surgi-
cal repair of skin closure with the modified technique based on our theory that dorsal penile skin
provides better blood supply. Our technique consisted of 4 steps: (1) Deglovement of the penile skin
till the base, (2) fixation of the penis at the base,(3) Initial fixation of skin at 12 O clock (4) Dorsal
longitudinal incision with a Byer's flap on either side (5) Excision of the ventral skin and reconstruc-
tion of the penoscrotal angle with the dorsal flap in the midline, (6) dartos fascia dissected from the
dorsal skin and used as 2
nd
layer over the urethroplasty.
RESULTS
The study 180 patients with all types of hypospadias Mean age at the time of surgery was 1.5 and
mean operative time was 120 minutes. Routine follow up was achieved at 1,3 and 12 months.
The commonest post op complication encountered was oedema which resolved within 2 weeks
in most, partially buried penis occurred in 5 patients post, 2 cases developed partial skin necrosis
which resolved by local cream application, this technique avoid most complication occurred in previ-
ous skin closure which was skin necrosis. We report good cosmetic results, preservation of penile
length and penoscrotal angle with our technique.
CONCLUSIONS
This modified new and simple technique of skin closure is very easy to adapt and perform with the
least complication rate and good cosmetic results in hypospadias surgery.
11:21–11:24
S7-7 (PP)
CRIPPLED HYPOSPADIAS: ARE THE RESULTS OF STAGED
REPAIR SATISFACTORY?
Haytham BADAWY
1
, Ashraf SAAD
2
, Mohammed YOUSSEF
3
, Ahmed FAHMY
3
,
Akram ASSEM
3
, Walid DAWOOD
3
, Samir ORABI
3
and Ahmed HANNO
3
1) University of Alexandria, Ped-urology, Alexandria, EGYPT - 2) Alexandria univ, Urology, Alexandria, EGYPT -
3) University of Alexandria, Urology, Alexandria, EGYPT
PURPOSE
Redo and crippled hypospadias where lack of vascularized flaps, ischemic and devitalized tissues
constitute a major challenge in front of a salvage repair. Staged repair represents an excellent
choice where such ischemic tissues are removed and replaced by a healthy graft to be used for ure-
thral reconstruction on different stages. Herein, we opt to evaluate the outcome of a single surgeon
use of staged repair using both buccal and inner preputial grafts in crippled cases of hypospadias.
MATERIAL AND METHODS
31 children collected from a prospectively designed database, operated a by a single surgeon with
a median age of 96 months (18–216). Meatus is posterior in 20, distal shaft in 11. Buccal graft was
used in 28 and preputial graft in 3 children during the first stage. Second stage was performed in
24, while 7 children did not yet have second stage performed. Tunica vaginalis flap was used in all
children as a second layer cover over the constructed urethra. Urethral drainage is maintained for
a period ranging from 7–10 days.
RESULTS
First stage was repeated in three children, overall success rate was 62.5 % for the completed
second stage, and complications were glanular dehiscence in 6 children (5 with posterior and 1 with
distal shaft meatus), complete dehiscence in 1, and urethrocutaneous fistula in 3 children.