Ahmad Abolyosr1. 1. Urology department, Qena University Hospital, 83523 Qena, Egypt. abolyosr66@yahoo.com
Abstract
OBJECTIVE: To evaluate the neourethra covering created by a vascularized overlapping double-layered dorsal dartos flap for preventing urethrocutaneous fistula in the Snodgrass hypospadias repair (tubularized incised plate). PATIENTS AND METHODS: Between March 2003 and January 2008, 156 boys (mean age, 4.5 years) were enrolled for hypospadias repair. Preoperative position of the urethral meatus was subcoronal in 37, at the distal shaft in 61 and mid-shaft in 58 boys. All patients underwent the Snodgrass hypospadias repair. The neourethra was then covered with an overlapping double-layered dorsal dartos flap before glans and skin closure. RESULTS: All 156 patients underwent successful reconstruction. With a mean follow up of 23 months (range 6-42), all boys had a satisfactory subjective cosmetic and functional result with a vertically oriented, slit-like meatus at the tip of the glans. No urethrocutaneous fistula or urethral stenosis occurred. CONCLUSION: As the neouretha covering is an integral part of the Snodgrass hypospadias repair, a dorsal well vascularized double-layered dartos flap is a good choice for preventing urethrocutaneous fistula formation. Copyright (c) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
OBJECTIVE: To evaluate the neourethra covering created by a vascularized overlapping double-layered dorsal dartos flap for preventing urethrocutaneous fistula in the Snodgrass hypospadias repair (tubularized incised plate). PATIENTS AND METHODS: Between March 2003 and January 2008, 156 boys (mean age, 4.5 years) were enrolled for hypospadias repair. Preoperative position of the urethral meatus was subcoronal in 37, at the distal shaft in 61 and mid-shaft in 58 boys. All patients underwent the Snodgrass hypospadias repair. The neourethra was then covered with an overlapping double-layered dorsal dartos flap before glans and skin closure. RESULTS: All 156 patients underwent successful reconstruction. With a mean follow up of 23 months (range 6-42), all boys had a satisfactory subjective cosmetic and functional result with a vertically oriented, slit-like meatus at the tip of the glans. No urethrocutaneous fistula or urethral stenosis occurred. CONCLUSION: As the neouretha covering is an integral part of the Snodgrass hypospadias repair, a dorsal well vascularized double-layered dartos flap is a good choice for preventing urethrocutaneous fistula formation. Copyright (c) 2009 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Authors: M Bertozzi; A Yıldız; B Kamal; M Mustafa; M Prestipino; M Yiğiter; H Al-Darawany; A Oral; N Nardi; A Appignani Journal: Pediatr Surg Int Date: 2011-09-21 Impact factor: 1.827