Hypospadias is a congenital abnormality caused by incomplete development of urinary meatus, in which the meatus is opened on the ventral side of penis instead of apex of glans. Its incidence rate is reported to be about 1 in 300 male live births. Hypospadias is divided into three types of posterior, middle, and anterior, regarding the position of meatus. In anterior type, meatal orifice opens either on distal penile shaft, on corona, or under the glans.
A variety of surgical techniques for hypospadias repair have been described over several decades, however, there is no single, universally applicable technique for hypospadias repair. Command of a technically straight forward repair with few complications and proven success and versatility in a reasonable range of hypospadias defects are desired goals. Several well – established techniques exist for the repair of all hypospadias defects.
One-stage repair has become the accepted procedure of choice. Since Duckett reported transverse preputial tabularized flap urethroplasty, one – stage repair has been gaining in popularity with several new one – stage techniques being mentioned. Current popular one – stage procedures are transverse island flap onlay and tabularized incised plate urethroplasty, as first reported by Elder et al. and Snodgrass, respectively.
About 80% of patients with hypospadias have a meatus in a coronal or subcoronal position. The perimeatal – based flap urethroplasty is commonly used for the primary correction of distal hypospadias. The most frequent complications after hypospadias repair are urethrocutaneous fistulae and meatal stenosis, which have been reported in up to 21% of patients.
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