VASCULARIZED DOUBLE-SIDED PREPUTIAL ISLAND FLAP WITH W-FLAP GLANULOPLASTY FOR HYPOSPADIAS REPAIR

Hypospadias surgery is one of the most challenging surgical interventi ons that still need further refinements for increased success rates. D uring the last 5 years, we operated on 26 mid-penile or proximal hypos padias cases by using vascularized double-sided preputial island flap and W flap glanuloplasty to achieve superior functional and aesthetic results. Follow-up period of the patients revealed a 92.3 percent succ ess rate with a single operation. Two cases developed fistula, which w as located at the proximal anastomosis site. However, they were repair ed in a second sitting without any additional problem. The basic aim i n hypospadias surgery is the correction of chordee, reconstruction of urethra, and sufficient ventral penile skin coverage in one stage with minimal complication. The use of vascularized tissue for urethral rec onstruction and ventral coverage is believed to have a superior healin g capacity with better functional and cosmetic outcome. On the other h and, adding W flap glanuloplasty to this technique avoids the risk of meatal stenosis. We conclude that by combining the two above-mentioned techniques, it is possible to cope better with this devastating conge nital deformity.