Video presentation of the second stage of a two-stage repair for proximal hypospadias: A safe and reproducible technique

• Published in: Journal of pediatric urology Vol. 10; no. 4; pp. 776.e1 - 776.e2
• Main Authors: Smith, Caroline M, Rooney, Aaron, Upasani, Anand, Mathur, Azad B
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2014
• Subjects: Braka stage 2; Child, Preschool; Humans; Hypospadias - surgery; Male; Pediatrics; Proximal hypospadias; Reconstructive Surgical Procedures - methods; Second-stage repair; Skin Transplantation; Suture Techniques; Urology; Braka stage 2; Proximal hypospadias; Second-stage repair
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2014.03.018

Abstract Objective The aims of proximal hypospadias repair are good cosmetic outcomes with low rates of complication, with a low number of operative exposures, before the age of genital difference realisation. Neo-urethral fistula and stenosis are well recognised complications; with international rates of 3.8–16% and 1.3–15.6% respectively. We present the key steps of the second of a two staged repair in video format. Method Video recording of the procedure performed on an 18-month-old with mid-penile hypospadias is presented. The steps are described; the importance of tension free tubularisation, layered urethral closure, suture technique, vascularised prepucal graft technique, optimal glanuloplasty, and penile shaft skin repair are highlighted. Result The child was brought back to the day ward for catheter removal at 7 days; follow-up in clinic showed good postoperative appearance. This technique has been performed on 31 boys with a fistula rate and stenosis rate favourable to the literature. Conclusion We demonstrate a two-stage technique by video format for proximal hypospadias which is reproducible and gives results comparable to the literature.