A NEW TECHNIQUE FOR DISTAL HYPOSPADIAS REPAIR - ADVANCEMENT OF A DISTALLY DEEPITHELIALIZED URETHROCUTANEOUS FLAP

We report on a new modification technique and the latest results of a procedure for treating cases of distal hypospadias with minimal or no chordee called advancement of a distally deepithelialized urethrocutan eous flap. This procedure incorporates correction of chordee, mobiliza tion of the urethrocutaneous flap, and advancement of the flap through a tunnel until it reaches the tip of the glans. A total of 30 childre n underwent treatment using this procedure in our clinic. Follow-up of the patients ranged from 2 months to 3 years. Cosmetic results were e xcellent in all the patients. Fistula formation has been observed in o nly one patient, possibly due to a surgical accident. This technique m ay only be applied in distal hypospadias patients with minimal or no c hordee in whom the meatus is localized to the coronal level or 0.5 cm proximal to it Patients with a short urethra or in whom the meatus is distally localized but with severe chordee are not candidates for this technique. In general, this technique is not applicable in patients w ith ventral penile curvature. We would like to emphasize that this rep air technique allows for simple and safe dissection of the distal uret hra composed of only mucosa without corpus spongiosum around it. This kind of distal urethra can be advanced easily to the tip of the glans penis with the help of the dermal component.