Efficacy of mid-scrotal fasciocutaneous flap for hypospadias repair

Abstract

Objective To explore a novel way of hypospadias repair using mid-scrotal fasciocutaneous flap as a multifunctional coverage for priorly failed hypospadias repair. Methods From February 2014 to January 2015, 12 cases of hypospadias were recruited. And their mean age was 8.4 (5-15) years. All their prior surgeries failed before. On the anatomic basis of scrotal skin blood supply, the mid-scrotal fasciocutaneous flap was liberated with a vascular fascia pedicle and transferred to vacancy in ventral penis. Results The mean follow-up period was 8.3 (6-12) months. There was no occurrence of diverticulum or urethral fistula. One case of urethral stricture under urethroscope was located at anastomotic stoma of buccal mucosa and original urethra at 2 weeks post-operation. And it was cured after dilatation. The long-term follow-up outcomes had no diverticulum, urethral fistula or stricture. All patients were satisfied with penile bending, urethral opening, voiding, penile appearance and scrotum. Conclusions For repeatedly operated patients, due to severe operative damage to flap in ventral penis, mid-scrotal fasciocutaneous flap is selected as a multifunctional coverage. Compared to ordinary ones, this method has the advantages of low tension, wider coverage and avoiding bloated feeling. It has decreased the hardness of redo surgeries. It deserves to be recommended because of its simplification, high rate of success, low rate of complications and pleasant cosmetics. Key words: Surgical flaps; Urologic surgical procedures; Hypospadias