An alternative way to cover ventral penile skin defect in Mathieu technique

Area of Science:

• Urology
• Pediatric Surgery
• Plastic Surgery

Background:

• The Mathieu technique is a satisfactory method for distal penile hypospadias.
• Ventral penile defects can occur post-Mathieu repair, requiring reconstructive techniques.
• Existing flap techniques for defect coverage include preputial island, Byar's, and Ombrédanne-Nesbit's flaps.

Purpose of the Study:

• To introduce and evaluate a new flap technique for cosmetically superior coverage of ventral penile defects after hypospadias surgery.
• To assess the functional and cosmetic outcomes of this novel flap in pediatric patients.

Main Methods:

• A longitudinal midline incision was made on the penile shaft to relax dorsal skin.
• The relaxed dorsal penile skin was advanced and sutured to cover the ventral defect.
• The resulting dorsal defect was closed using the prepuce.
• The technique was applied to nine patients (two with chordee, seven without) who had defects not amenable to primary closure.

Main Results:

• Excellent cosmetic and functional results were achieved in all nine patients.
• No patient or parent expressed dissatisfaction with the cosmetic outcome.
• One case of fistula complication occurred, which resolved spontaneously.

Conclusions:

• The described flap technique provides excellent cosmetic results for covering ventral penile defects post-hypospadias repair.
• This method offers a valuable alternative for achieving superior aesthetic outcomes in reconstructive penile surgery.
• The technique is safe and effective, with minimal complications.