Results of preputial reconstruction in 77 boys with distal hypospadias

Purpose: There is growing interest in preputial reconstruction combined wit h hypospadias repair. We retrospectively analyzed its results for future de velopments and patient information. Materials and Methods: We evaluated 77 boys who underwent distal hypospadia s repair combined with preputial reconstruction to determine complications, risks and failures. Results: At a mean followup of 2.5 years 52 patients had an anatomically no rmal penis with a normal retractable foreskin, while 25 (33%) presented wit h a complication. The most common complications were partial dehiscence, an d fistula of the prepuce and urethra. There was a complication of the recon structed foreskin only in 16 cases (21%), a combined problem with the recon structed foreskin and reconstructed urethra in 7 (9%), and a problem with t he reconstructed urethra in 2 (3%). Of the 25 patients with complications 1 9 underwent reoperation with closure of the fistula or dehiscence and 5 wer e circumcised, while in 1 the parents accepted the minor cosmetic problem a nd refused reoperation. Conclusions: Preputial repair combined with hypospadias repair may lead to anatomically correct reconstruction of the penis at the cost of a 33% compl ication rate. Parents are informed about this risk and to date in 15% of al l boys with distal hypospadias the parents have elected preputial reconstru ction.