[The treatment of distal hypospadias in children]

The authors propose a new treatment of distal hypospadia without distortion of the penis. From 1990 to 1994 the operation was performed in 193 boys aged from 4 months to 14 years. The new procedure was tried in 67 patients. It consists in dissection of the skin flap along the ventral surface of the penis with a special cut on the glans penis. The proximal part of the flap is isolated and placed on the glans penis. The urethra is formed on the urethral catheter using interrupted inverting subcuticular sutures (prolen 6/0). The urethra is covered with the preputial skin transformed from the dorsal penis. The edges of the dissected glans penis are sutured with cutaneous preputial flap in the frenulum region to increase the urethral diameter in the distal part. The 6-48-month follow-up results are good: postoperative complications occurred in 7.4% of cases instead of 15.5%: urethral fistulas and postoperative wound opening were registered in 3 and 2 patients, respectively. Reoperations were successful. Cosmetic and urodynamic results were good. The above method of urethral reconstruction is a method of choice in the treatment of distal hypospadia.