A New Technique for Skin Closure in Hypospadias: Ipsilateral Penoscrotal Approximation for Closure

Abstract

Sixteen patients, between 2 and 45 years old, with hypospadias underwent repair with our new skin closure procedure called ipsilateral penoscrotal approximation for closure (IPSAC). Complete functional success was obtained in all 6 patients with distal hypospadias and in 7 of 10 patients with proximal hypospadias. Meatal regression and urethrocutaneous fistula were complications in one-stage repair. Another urethrocutaneous fistula resulted from fifth-stage repair in the case of an adult hypospadias cripple. Cosmetically, there were two cases with unsightly thickening of the base of the penis in this early series. It was found that this IPSAC procedure had two major advantages: it provided (1) a tension-relieving skin closure, and (2) correction of scrotal deformity, especially in one-stage repair with the parameatal flap and in multi-staged repair with absolute penile skin deficiency.

Use of Testosterone Ointment before Hypospadias Repair

“…3). 9 patients with bifid scro tum underwent urethroplasty with parameatal foreskinflap [1,13] with (4 patients) or without (5 patients) the ipsilateral penoscrotal approximation technique [3], Pri mary success was obtained 4 of 5 (80%) and 3 of 4 (75 %), respectively.…”

“…For psy chological and social reasons, we think hypospadias re pair should be completed before the age of 4 years. We have reported our experience with one-stage repair in severe hypospadias [1][2][3]. However, a small penis and/or a shortage of foreskin to cover the penis are often obsta cles to one-stage repair.…”

Onlay Urethroplasty with Parameatal Foreskin Flap for Distal Hypospadias

“…(fig. IK, 2H), as well as the wound-dressing and postoperative cares [2,9]. [7], Principally, our tech nique is essentially in the same trend with these prede cessors in that patch graft is preferred to the tubularization and well-vascularized flap is used rather than the free graft.…”