Abstract：
OBJECTIVES:To describe a modified onlay preputial island flap (OIF) urethroplasty to also be used in patients requiring urethral plate transection for penile straightening. METHODS:A total of 14 cases with primary severe hypospadias underwent the modified OIF urethroplasty as follows. After skin degloving, the corpora cavernosa were dissected ventrally. The urethral plate was mobilized and, if curvature >30° persisted, transected just proximally to the coronal sulcus. A pedicled preputial island flap was elevated and placed as an onlay to create the neourethra. It was sewn to the margins of the urethral plate proximally and distally. In contrast, in the portion of the shaft without a plate, it was sewn directly to the albuginea of the corpora cavernosa with 2 parallel suture lines. Glanuloplasty and skin closure followed as in standard onlay repairs. RESULTS:After a median follow-up of 7 months (range 5 to 27), 3 patients (21%) developed complications requiring additional surgery (1 simple fistula, 1 partial urethroplasty breakdown, and 1 ballooning of the neourethra). None of the remaining patients presented with residual curvature or voiding problems, according to the parental report. CONCLUSIONS:The results of the present preliminary experience suggest that OIF urethroplasty can also be performed in cases requiring urethral plate transection. It can be accomplished by suturing the preputial flap directly to the albuginea of the corpora cavernosa. Although we acknowledge that a larger number of cases and longer follow-up are necessary, we believe this technique should be incorporated into the armamentarium of hypospadiologists.
journal_name
Urologyjournal_title
Urologyauthors
Rigamonti W,Castagnetti Mdoi
10.1016/j.urology.2010.09.048subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1498-502issue
6eissn
0090-4295issn
1527-9995pii
S0090-4295(10)01821-2journal_volume
77pub_type
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