Comparative Study Between Parameatal Lateral Based Flap Technique and Longitudinal Preputial Flap Technique for Distal Penile Hypospadias Repair

Abstract

SUMMARY AND CONCLUSION O ur study was conducted on 40 patients with distal hypospadias and aging more than 6 months old, admitted through the outpatient clinic of Urology in Ain Shams University Hospitals through the period from 1/2016 to 6/2016 divided into two equal groups. Group A: Underwent repair by parameatal lateral based flap technique. Group B: Underwent repair by longitudinal preputial flap technique. The success rate of patients of group A with one procedure was 75%, with fistula formation in 10% of cases, penile rotation in 5% of cases and wound dehiscence in 10% of cases. In group B, the success rate with one procedure was 65%, with fistula formation in 15% of cases, penile rotation in 10% of cases, wound dehiscence in 5% of cases and penile oedema in 5% of cases. Our results in comparison to the two groups showed statistically insignificant differences between the two groups. In comparison to other studies, our results are comparable to them as regard the cosmetic appearance satisfaction, rate of fistula formation, meatal stenosis and other complications. On the basis of our study, we concluded that comparing the use of parameatal lateral based flap and the use of longitudinal preputial flap in distal hypospadias repair showed statistically insignificant difference between the two groups, but parameatal lateral based flap seemed to be useful in patients that are previously circumcised, also in patients that had small inadequate glans the parameatal lateral based flap seemed to be better than the longitudinal preputial flap where the preputial flap was difficult to be placed in a narrow glanular groove. Also longitudinal preputial flap seemed to be useful in uncircumcised patients who had hypoplastic urethral plate and hypoplastic ventral dartos where the parameatal lateral based flap would have less vascular pedicle.