Glanuloplasty By Ventral Skin Interposition In Hypospadias Repair: Preliminary Report

Main Category: Urology / Nephrology
Article Date: 26 Apr 2009 - 0:00 PDT

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UroToday.com - In a recent article from the World Journal of Urology, Drs. Hassan Shaker and Mahmoud Ezzat described a technique with a triangular skin flap interpositioned between the developed glanular wings to cover the neourethra in patients with small glans.

It is rather simple and can be tailored to any hypospadias surgery. The source of this flap was either the outer preputial skin in eight patients, subjected to double onlay preputial flaps; a skin flap developed from the ventrolateral penile skin, in two cases repaired by Snodgrass procedure; and another by Mathieu flip flap repair. Although subject to bias since no true scoring could be performed, they felt that the cosmetic appearance was good in all cases except one. In this case the distortion of the glans was due to the use of excessive skin for interpositioning. There was one urethracutaneous fistula; three patients experienced edema of the interpositioned skin that resolved on it own. They felt that it provided a tension-free closure of the glans.

They acknowledge that this report is preliminary, and long-term data and a larger number of patients should be treated with this procedure before a final conclusion is reached. Nonetheless, the fact that they had no meatal stenosis is very promising.

Shaker H, Ezzat M
World J Urol. 2009 Feb 20. Epub ahead of print.
doi:10.1007/s00345-009-0386-0

Written by UroToday.com Medical Editor Pasquale Casale, MD

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