Abstract
To compare the postoperative effects of Onlay transverse island preputial flap and Onlay transverse free island preputial graft for midshaft hypospadias repair. Retrospective analysis of clinical data of patients with midshaft hypospadias who underwent hypospadias repair in our hospital from January 2013 to December 2018. Among them, 49 children repaired with Onlay transverse island preputial flap, they were operated at the age from 14 months to 81 months. 10 children repaired with Onlay transverse free island preputial graft. The age at surgery was from 15 months to 51 months. The length of the urethroplasty and surgical complications were compared. Summarized and analyzed the maximum urinary flow rate of some patients after operation. Follow-up ranged from 3 to 72 months. In the children who underwent Onlay transverse island preputial flap, the neourethra was 1.30–3.50cm. There were 11 cases of fistula, 1 case of glans dehiscence, and 1 case of diverticulum. Ten children were treated with Onlay transverse free island preputial graft. The neourethra was 1.20–2.50cm. Two cases of fistula occurred after operation. There was no significant difference in the length of the urethra (Z = -1.732 P=0.083) and the incidence of postoperative complications (χ2=0.001, P=0.973) between the two surgical methods. There was no significant difference. Fourteen patients finished the uroflowmetry 3 months after surgery. Twelve patients in the traditional Onlay group had a maximum urinary flow rate was 3.5–13.6 ml/s. In the free graft Onlay group, the maximum urinary flow rate was 9.6–15.7 ml/s. Ten of the 14 patients (71%) were within the 90th percentile for age-matched voiding nomograms. Onlay transverse free island preputial graft the same as Onlay transverse island preputial flap, could be a good choice for midshaft hypospadias repair. It could get a good maximum urinary flow rate and cosmetic result.
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