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Outcomes of Onlay Island Flap Technique in Shallow Urethral Plate Hypospadias - a 3 Years’ Experience - Abstract

Leily Mohajerzadeh, Ahmad Khaleghnejad, Naser Sadeghian, Alireza Mirshemirani, Mohsen Rozroukh, Alireza Mahdavi, Sareh Pourhassan



Objective: This study aimed to evaluate the outcomes of using onlay island flap technique in the repair of hypospadias with shallow urethral plate.

Patients and methods: In this prospective study between June 2012 and June 2014, we performed onlay island flap procedure for the repair of hypospadias with shallow urethral plate - less than 6 millimeters. This technique was selected for all types of hypospadias except subcoronal type. Nesbit's dorsal plication procedure was performed for chordee. In cases with very small glans, urethroplasty was performed without glansoplasty.

Results: Twenty three patients with mean age of 30 months (range 10-60 months) underwent onlay island flap repair; all had a shallow urethral plate of less than 6 mm, 3 had a very small glans and 18 had chordee. Meatus was located in distal shaft in 5 cases, midshaft in 8, proximal in 6 and penoscrotal type in 4 patients. Chordee was corrected with Nesbit's dorsal plication in 16 cases. Complications were: meatal stenosis in 2 cases and urethrocutaneous fistula in 2 patients and all were repaired surgically. Mean follow up time was 13 months (range 3-20 months). All cases that had glansoplasty have excellent esthetic appearance.

Conclusion: This technique offers acceptable results regarding meatal stenosis, urethrocutaneous fistula and good esthetic outcome. 

Keywords: onlay island flap, hypospadias, urethroplasty


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