Related Experiment Video
Updated: Jan 5, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Single-repair for primary proximal hypospadias. Lessons learned after 196 primary repairs]
M Castañón1, J Prat-Ortells1, L García-Aparicio1
1Hospital Sant Joan de Déu. Esplugues de Llobregat (Barcelona).
Purpose:
Proximal, scrotal and perineal hypospadias challenge the surgeon. After 40 years devoted to hypospadias surgery, the senior author summarizes her experience, share her tricks and shows that almost any hypospadias can be fully repaired in one surgery.
Methods:
Retrospective review and discussions of a large series of consecutive proximal hypospadias treated in one surgery by the same team from 1999 to 2016.
Results:
196 patients were operated. 68% of all patients were successfully repaired after the surgery. All hypospadias were treated using one of the following techniques: onlay double flap, tubularized preputial flap or mucosal grafts (only until 2005). Urethrocutaneous fistula was present in 25% of cases, but only 13% of patients needed other further surgical procedures.
Conclusion:
Cutaneous incisions design is fundamental in hypospadias repair. When the incisions follow the natural folds that appear in penile and scrotal skin, it's possible to obtain optimal flaps for both urethroplasty and skin coverage (even avoiding the need for mucosal grafts). Consequently, almost all kinds of hypospadias can be repaired in one surgery with very good long-term results.
