ESPU Congress 2018 - Abstract Book

73 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.