An alternative way to cover ventral penile skin defect in Mathieu technique

Mathieu technique is used satisfactorily in distal penile hypospadias witho ut chordee or with minimal chordee. After using this technique, a large def ect may sometimes appear on the ventral surface of the penis. To cover the defect, a few techniques, including preputial island flap, Byar's flap and Ombredanne-Nesbit's flap, are used. We describe a new flap to cover the def ect more cosmetically. Twenty-four patients ranging in age from one year to 14 years (median age 6.5 years) were operated on. In the patients for whom the defect could not be covered primarily, a longitudinal incision was mad e along the midline through the penile shaft skin from penile radix up to t he border of preputial skin. The relaxed penile skin, which was incised on the dorsal surface, could be approached and sutured easily on the ventral s urface without stretching. The new defect that developed on the dorsal surf ace was closed with the prepuce matching the defect. Nine patients, two wit h chordee and seven without chordee, underwent this technique. The cosmetic and functional results were excellent in all patients and none of the pati ent's parents complained about the cosmetic aspect. Only one fistula compli cation, which healed spontaneously, developed on the 20th postoperative day . Considering these results, we may conclude that excellent cosmetic result s can be accomplished by the use of this flap technique.