Repair of hypospadias fistula using a penile skin advancement flap with penile dartos interposition

摘要

Objective: We aim to report a single surgeon's experience of using a penile skin advancement flap with penile dartos interposition for hypospadias fistula repair. Patients & methods: All hypospadias fistula repairs performed in our unit by this paediatric urologist between 2000 and 2012 were identified from a prospectively recorded database. Patients' case-notes were reviewed retrospectively gathering data on surgical technique, post-operative care and fistula recurrence on follow-up. Only those boys having repair by this advancement flap technique were included. A urethral catheter was left in situ in all patients for 5-7 days. Repairs performed using other techniques were excluded. Results: 20 consecutive patients had fistula repair by the advancement flap technique. This was the primary repair in 19 boys, and was repair of a third fistula occurrence in one. The median age at fistula repair was 3.7 years (1.6-15.3). The median follow-up was 4 months (3-73). One boy failed to attend any follow-up. No recurrence has yet been identified in any of the 20 patients. Conclusion: The penile skin advancement flap with dartos interposition technique was very successful in our series in both primary fistula repair, and in a patient who had multiple previous operations.