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Updated: Nov 24, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Two different routes for transferring the pedicled preputial island flap for hypospadias in children: A comparative
Jia-Bin Jiang1, Deng-Xin Fan1, Yin Zhang1
1Department of Urology, Anhui Provincial Children's Hospital, Hefei, Anhui 230051, China.
Insights
This study compared two pedicled preputial island flap transfer methods for hypospadias surgery. The middle orifice technique, while longer, resulted in shorter catheter times and fewer complications, suggesting its clinical benefit.
Area of Science:
- Urology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Hypospadias is a congenital condition requiring surgical correction.
- The pedicled preputial island flap is a common surgical technique.
- Different flap transfer routes may impact surgical outcomes.
Purpose of the Study:
- To evaluate the surgical features and clinical outcomes of two pedicled preputial island flap transfer routes for hypospadias.
- To compare the efficacy of transferring the flap through the middle orifice of the vascular pedicle versus from one side of the penis.
Main Methods:
- Retrospective analysis of 122 hypospadias cases.
- Two groups: 80 cases (control) with flap transfer from one side, 42 cases (observation) with transfer through the middle orifice of the vascular pedicle.
- Comparison of intraoperative and postoperative data, including operation time, catheter-indwelling time, urethral length, and complication rates.
Main Results:
- Observation group had longer operation time (164.43 ± 25.03 min) vs. control group (134.71 ± 32.37 min) (P < 0.01).
- Observation group showed significantly shorter catheter-indwelling time (2.93 ± 0.97 wk) vs. control group (3.68 ± 0.73 wk) (P < 0.01).
- Lower postoperative complication incidence in the observation group (9.52%) compared to the control group (25.00%) (P < 0.05).
Conclusions:
- Transferring the pedicled preputial island flap through the middle orifice of the vascular pedicle leads to shorter catheter-indwelling time and reduced postoperative complications.
- Despite a longer operative duration, this technique offers significant advantages for hypospadias repair.
- The middle orifice transfer route is recommended for wider clinical application in hypospadias surgery.
Objective:
To summarize the experience in the surgical treatment of hypospadias by analyzing the operation features and clinical effects of two different routes for transferring the pedicled preputial island flap.
Methods:
This retrospective study included 122 cases of hypospadias treated by transferring the pedicled preputial island flap, 80 from one side of the penis (the control group) and the other 42 through the middle orifice of the vascular pedicle (the observation group). We recorded the intra- and postoperative data and compared them between the two groups.
Results:
The operation time was significantly longer in the observation group than in the control (［164.43 ± 25.03］ vs ［134.71 ± 32.37］ min, P < 0.01), but the catheter-indwelling time was dramatically shorter in the former than in the latter group (［2.93 ± 0.97］ vs ［3.68 ± 0.73］ wk, P < 0.01). There was no statistically significant difference in the length of the reconstructed urethra between the two groups (［2.86 ± 0.71］ vs ［2.83 ± 0.82］ cm, P = 0.863). A 6- to 12-month follow-up showed a significantly lower incidence of postoperative complications in the observation than in the control group (9.52% vs 25.00%, P < 0.05).
Conclusions:
Transferring the pedicled preputial island flap through the middle orifice of the vascular pedicle, though taking a longer time than that from one side of the penis, has the advantages of a shorter catheter-indwelling time and a lower incidence rate of postoperative complications, and therefore deserves wide clinical application.
