Two-stage hypospadias repair: a method applicable to all types of hypospadias.

OBJECTIVE: To assess the results of two-stage repair in proximal hypospadias and cases of distal hypospadias with chordee, revision surgery and in circumcised cases. DESIGN: Prospective study. PLACE AND DURATION OF STUDY: Combined Military Hospital, Kharian and Pano Aqil, from July 1998 to June 2002. PATIENTS AND METHODS: Nineteen patients, with distal as well as proximal hypospadias, underwent two-stage hypospadias repair during the last 04 years. Splitting of glans and full thickness grafting was carried out in the first stage. Tubularization was carried out 3-6 months later and the repair was covered with waterproofing layer. The results were evaluated. RESULTS: Distal hypospadias was seen in 13 patients, 06 cases had proximal hypospadias, 08 patients had undergone repair previously by different techniques and 05 cases were circumcised. Chordee was seen in 12 cases. Common age of presentation was below 5 years. Adequate cosmetic and functional results were achieved in all these cases. Fistula occurred in 02 cases and meatal stenosis was seen in 01 case, which responded to regular dilatation. CONCLUSION: Two-stage hypospadias repair gives excellent cosmetic and functional results in all cases of proximal hypospadias and cases of distal hypospadias with chordee, revision surgery and circumcised cases.