Outcome of Double Layer UrethroplastyWithout Flap in Mid and Distal Penile Hypospadias

Hypospadias is the absence of external urethral meatus in the tip of the glans but present in the ventral surface of the penis. Hypospadias surgery is challenging and changing. Many modifications have been done to reduce the complications. Currently urethroplasty with flap coverage is widely used but flap itself induces some complications. Aim of this study was to evaluate the outcome of double layer urethroplasty in mid and distal penile hypospadias without flap. This was a prospective type of observational study conducted in the department of pediatric surgery Mymensingh Medical College Hospital (MMCH) and several other private hospitals from January 2021 to December 2023. Total 61 patients were enrolled among them 7 patients failed the follow up schedule; finally 54 patients were included in this study. Age ranges from 2-12 years with mean age 5.8±2.55 years. Maximum 26 (48.14%) patients had distal penile hypospadias followed by coronal hypospadias 11 (20.37%). Mean operative time was 65.0±10.0 minutes for all types. Among the 54 patients, 48(88.88%) were recovered uneventfully and 6(11.11%) patients developed one or more complications. Urethro-cutaneous (U-C) fistula 5(9.25%) were the most common complications followed by meatal stenosis 3(5.5%) and residual chordee 1(1.8%). This study shows double layer urethroplasty without flap in mid and distal penile hypospadias surgery is safe and feasible as other procedures with flap.