Lateral-Based Onlay for Recurrent Hypospadias Surgery (LABOR); A Multicentre Study
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Published on: July 8, 2025
Mohamed Fawzy1, Michael Sennert2, Marios Marcou3
1Hypospadias Centre, Department of Pediatric Surgery, Sana Klinikum Offenbach Hospital, Germany; Department for urology and paediatric urology, University of Bonn, Bonn, Germany.
Objective:
To report long-term outcomes of the Lateral Based Onlay Flap (LABOR) technique for recurrent midshaft and proximal hypospadias across multiple centers.
Patients And Methods:
A retrospective review was conducted of patients undergoing LABOR repair for recurrent/complicated mid-penile and proximal hypospadias between 2014 and 2024 in 3 centers across 2 continents. Patients with severe curvature requiring urethral plate division or inadequate penile skin were excluded.
Principle Of The Technique:
Two glandular wings are mobilized. The lateral penile skin is mobilized and advanced, medially, maintaining its blood supply and sutured to midline skin and folded as an onlay flap to reconstruct the neourethra to the glans tip.
Results:
Among 397 referred patients, 97 patients met the inclusion criteria. Median age was 3 years (range 22 months-49 years). Follow-up ranged from 1-11 years. Forty-four patients (45%) maintained long-term follow-up for more than 5 years. Complete healing without complications occurred in 77 patients (79%). Complications occurred in 20 patients (21%) including glans dehiscence (8%), fistula (9%), and meatal stenosis (3%). All were successfully corrected with a single procedure.
Conclusion:
LABOR is an effective option to correct recurrent mid-penile and proximal hypospadias without severe chordee with acceptable complication rates (21%) and favorable long-term outcomes.
