Related Experiment Video
Updated: Jun 14, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Factors affecting the outcome of foreskin reconstruction in hypospadias surgery
Brice Antao1, Nick Lansdale, Julian Roberts
1Paediatric Surgical Unit, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK. briceantao@doctors.org.uk
Insights
Foreskin reconstruction combined with hypospadias repair shows high success rates, especially for distal hypospadias. This approach improves cosmetic and functional outcomes, with lower complication rates when using specific techniques and sutures.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
- Genitourinary Surgery
Background:
- Hypospadias repair complications remain a concern despite technique advancements.
- Foreskin reconstruction is often integrated into hypospadias repair procedures.
Purpose of the Study:
- To evaluate factors influencing the success of foreskin reconstruction during hypospadias repair in children.
- To analyze foreskin-related complications following primary hypospadias repair with reconstruction.
Main Methods:
- Retrospective analysis of 408 primary hypospadias repairs with foreskin reconstruction over 23 years.
- Categorization of hypospadias severity (coronal, glanular, subcoronal, distal penile).
- Comparison of outcomes for meatal advancement/distal urethral tubularization versus flip-flap procedures.
Main Results:
- Success rates were 92% for meatal advancement/distal urethral tubularization and 72% for flip-flap.
- Overall foreskin complication rate was 10%, with an 8% urethral fistula rate.
- Distal hypospadias cases showed better outcomes with interrupted polyglactin sutures.
Conclusions:
- Foreskin reconstruction can achieve good cosmetic and functional results when combined with various hypospadias repair techniques.
- Optimal outcomes are associated with distal hypospadias and the use of interrupted polyglactin sutures.
Objective:
Despite ongoing refinement of numerous techniques, the incidence of complications following hypospadias repair is still significant. The aim of this study is to evaluate the factors that affect the success in childhood of foreskin reconstruction with hypospadias repair.
Materials And Methods:
A retrospective study was carried out of all primary hypospadias repairs with foreskin reconstruction (n=408) over the last 23 years. The hypospadias was coronal in 160 (39%), glanular in 114 (28%), subcoronal in 78 (19%) and distal penile in 56 (14%) cases. Foreskin reconstruction was included in 362 cases suitable for a meatal advancement (191) or distal urethral tubularization (171), and 46 cases for a flip-flap procedure (37 Mathieu, nine Barcat). Outcome analysis was of foreskin-related complications post surgery.
Results:
Foreskin repair was successful in 333 cases (92%) that underwent meatal advancement/distal urethral tubularization, and 33 (72%) that underwent a flip-flap operation. Complications related to the foreskin occurred in 10% of the whole group with a urethral fistula rate of 8%. The median age at surgery was 13 months (2-120 months), and the median follow-up period was 11 months (1-100 months).
Conclusions:
A good cosmetic and functional outcome can be achieved with foreskin reconstruction combined with a variety of hypospadias repairs. The outcome in this series was better in cases of distal hypospadias using interrupted polyglactin sutures.
