Use of preputial island flap for penile skin reconstruction in hypospadias

Abstract

Introduction: Providing the material for penile reconstruction after release of chordee associated with hypospadias is challenging. We have used the preputial vascularized island flap for this purpose. We report the results of this prospective study. Materials and Methods: One hundred and twelve boys ranging from 13 months to 12 years of age were enrolled in this study. The location of meatus ranged from midshaft to glanular and all of them had associated penile curvature from 10 to 40 degrees. The preputial skin vascularized flap was created and used for covering the defect in all cases. The underlying dartus tissue of the flap also lied on the uretheral suture line to prevent the formation of fistula. The follow up period ranged from 2 months to 72 months. All patients received caudal anesthesia for postoperative pain management. Results: All patients had skin defects on the ventral surface of their penile shaft after correction of penile curvature. The ischemia and necrosis of the flap developed in 5 cases however these were in initial phases of the study. In 20 cases the appearance of the flap seemed liked a hyperthrophied loose patch on the ventral aspect of penis. These cases went on to have a good appearance over time. Only in two of these cases a second operation to refashion the flap was needed. Conclusion: Thepreputial island flap is a safe method for covering the new urethra and penile skin defects, with good cosmetic results.