Arch Plast Surg.  2013 Nov;40(6):766-772. 10.5999/aps.2013.40.6.766.

Correction of Problematic Hypospadias with Dartos Fascia-Reinforced Flap and Slanted Incision of Fistula

• Choi DS
• Lee JW
• Yang JD
• Chung HY
• Cho BC
• Byun JS
• Choi KY

• KMID: 2167866
• DOI: http://doi.org/10.5999/aps.2013.40.6.766

Abstract

BACKGROUND
Hypospadias is the most common congenital malformation of the male urinary tract, wherein the urethral opening is located proximal to the normal site. Tubularized incised-plate urethroplasty reconstruction, and its efficacy, remains controversial due to the high recurrence rate. This study aimed to evaluate the results of dartos fascia-reinforced flap surgery in hypospadias patients with previous operative complications.
METHODS
Nine patients (mean age, 12 years) who had previous one- or two-stage repair with TIP urethroplasty and suffered from urethrocutaneous fistulas or fissures as complications, underwent dartos fascia-reinforced flap surgery in our clinic between January 2010 and December 2012. The mean postoperative follow-up period was 6 months.
RESULTS
Among the 9 patients, 7 had complete correction. In all the patients, the maximum uroflow angle was >45degrees. No patient complained of an unnatural urinating position. The patients and parents gave very high satisfaction scores (4.7 points) with regard to the appearance of the outer genitalia.
CONCLUSION
The dartos fascia-reinforced flap could be a useful and reliable option for complications of hypospadias repair or fissure with the prepuce preserved, given that histological aspects vary and that the possibility of recurrence in the glanular region is high.

Keyword

Urethra; Fistula; Surgical flaps; Hypospadias

MeSH Terms

Female
Fistula*
Follow-Up Studies
General Surgery
Humans
Hypospadias*
Male
Parents
Recurrence
Surgical Flaps
Urethra
Urinary Tract