One-stage penile cutaneous island flap repair for hypospadias in circumcized patients

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Congenital hypospadias repair is complex, particularly in previously circumcised infants.
• Routine infant circumcision in some regions necessitates hypospadias repair in circumcised patients.
• Standard hypospadias repair techniques can be challenging in the absence of a foreskin.

Purpose of the Study:

• To evaluate the efficacy of a one-stage transverse penile cutaneous island flap repair for congenital hypospadias in circumcised infants.
• To assess the functional and cosmetic outcomes of this specific surgical technique.
• To report complication rates associated with the transverse penile cutaneous island flap repair.

Main Methods:

• A retrospective review of 16 circumcised patients who underwent a one-stage transverse penile cutaneous island flap repair for congenital hypospadias.
• Surgical technique involved creating a transverse penile cutaneous island flap for urethral reconstruction.
• Outcomes were assessed based on graft take, complication rates (e.g., urethrocutaneous fistulae), and functional and cosmetic results.

Main Results:

• The transverse penile cutaneous island flap graft was successful in all 16 patients.
• Only 2 cases (12.5%) developed urethrocutaneous fistulae, which were successfully managed with a rotation flap.
• Good functional and cosmetic results were achieved in 81% of patients, with the remainder showing fair results.
• No complete repair failures were reported.

Conclusions:

• The one-stage transverse penile cutaneous island flap repair is a safe and effective method for treating congenital hypospadias in circumcised infants.
• This technique yields high rates of successful functional and cosmetic outcomes with a low complication profile.
• It represents a valuable reconstructive option for challenging hypospadias cases in circumcised patients.