A review of operative treatment for 322 cases of hypospadias in the past 15 years

Objective To evaluate different operative procedures for hypospadias. Methods 322 cases of operatively treated hypospadias were reviewed.Orthotopic skin flap urethroplasty, pedicle skin flap urethroplasty and free tissue urethroplasty procedures were evaluated. Results In orthotopic skin flap urethroplasty,penile skin flap urethroplasty was undertaken in 26 with a satisfactory rate of 69.2%;33 cases underwent penilie skin tube urethroplasty with a success rate of 69.7%.In pedicle skin flap urethroplasty,146 underwent scrotum pedicle skin flap urethroplasty with a success rate of 80.8% and 65 underwent prepuce lamina pedicle skin flap urethroplasty with a success rate of 81.5%.In free tissue urethroplasty, free internal prepuce lamina urethroplasty was carried out in 9 with success in 7.One case underwent buccal mucosa urethroplasty has been a failure.Bladder mucosa graft urethroplasty was carried out in 42 with a success rate of 88.1%. Conclusions Many factors should be considered on choosing the operative procedure as each procedure has it own advantages and disadvantages.Bladder mucosa graft urethroplasty seems to render a higher success rate and the distensible characreistics of the mucosa approximate closer the normal urethra.