Clinical application and single factor analysis of onlay island flap urethroplasty

Abstract

Objective To investigate the indications and complications of onlay island flap urethroplasty in hypospadias. Methods Retrospective analysis 51 cases who received the onlay urethroplasty from Mar.2005 to Sep.2012 at the First Affiliated Hospital of Guangxi Medical University.Their ages were from 2 years to 12 years, the median age was 4 years and 3 months.Forty-three cases received the operation for the first time, 8 cases were re-operation.The prepuce island flaps were implemented in all cases.Factors which contributed to the successful operation ratio were compared, such as the levels of penile curvature, the lengths of urethral defects, first operation or reoperation, the size of glans. Results The operation achievement ratio was 82.4%(42/51 cases). There were 7 cases urethrocutaneous fistula(6 cases were then cured by reoperation, 1 case healed naturally). One case had urinary meatus had retraction.There was another case with persisting penile curvature.Some differences in factors had no statistical significance, such as the levels of penile curvature, the lengths of urethral defects, first operation or reoperation(χ2=0.249, 0.287, 1.208; all P>0.05). The difference in glans size had statistical significance(χ2=3.393, P<0.05). Conclusions Onlay urethroplasty was suitable for the cases of coronary sulcus of penis and extremitas anterior penis, but for proximal cases, this therapy must be applied very carefully because of persisting penile curvature.For some reconstruction cases, Onlay urethroplasty was suitable, but the island flap must be designed flexibly.Urethrocutaneous fistula was the most complication, especially in some small flat glans. Key words: Hypospadias; Urethroplasty; Indication; Complication