One-stage urethroplasty by tubularization of reconstructed urethral plate using preputial island flap in proximal hypospadias with severe chordee

Objective To explore the efficacies of a modified prepuce transverse island tube urethroplasty for urethral stricture.Methods The procedure was conducted in 15 cases from March 2012 to September 2013 at our hospital.Their age range was 7-23 months.All cases had proximal hypospadias with small glans and severe penile chordee.The lengths of penis and urethral defect were 2.5-4.0 and 4.0-6.0 cm respectively.One-stage urethroplasty was performed.And a 6Fr gastric tube for urinary drainage was removed at Week 2 post-operation.Results The follow-up period was 3-17 months.Urinary fistula occurred in 3 cases (coronary sulcus fistula,n =1 ; penile fistula,n =2).There was no urinary stricture or diverticulosis.The maximal urinary flow rate ranged from 7.2 to 11.5 ml/s at Month 3 post-operation.And 13 parents were satisfied with cosmetic appearance.Conclusions Ure throplasty by tubularization of reconstructed urethral plate with preputial island flap for proximal hypospadias with severe chordee may reduce the incidence of urethral stricture without increasing the occurrence of fistula. Key words: Child;  Hypospadias;  Urologic surgical procedures