Correcting Glanular Dislocation in Hypospadias With Up-to-Tip Technique and Double Wing Flaps

Abstract

The surgical treatment of hypospadias contains urethral reconstruction and correction of penile curvature. In some severe type of hypospadias, it also needs correction of penoscrotal transposition and cleft of scrotum. However, there are few literatures that refer to the correcting of deformity of glanular dislocation. This study aimed to correct the deformity of glanular dislocation in patients with hypospadias with up-to-tip technique and double wing flaps. From May of 2011 to September of 2012, 49 patients who underwent hypospadias with glanular dislocation repairing received up-to-tip technique to correct the deformity of glanular dislocation in our department by a single surgeon (J.Z.). An X-shaped incision was made in the ventral median of glans, and the glans was dissected from the penis cavernosus, then 2 wing-shaped flaps appeared. The 2 sides of flaps were rotated and lifted with new urethra inside. The divergent glans flaps were closed with vertical mattress suture. Follow-up was from 12 to 30 months. All patients had excellent cosmetic results immediately after the operation. The glans was straight and was upturned obviously. The wing flaps of glans were partially dehisced in 2 (4.08%) cases after the operation. The other patients had good wound healing. No urethral stricture in distal urethra was observed. Up-to-tip technique and double wing flap can effectively correct the deformity of glanular dislocation in the patients with hypospadias. After the operation, the glans configuration was improved.