Proximal hypospadias with small flat glans: the lateral-based onlay flap technique

PurposeThe lateral-based onlay (LABO) technique for patients with proximal hypospadias associated with flat glans and report of the follow-up.Materials and MethodsBetween January 2004 and December 2010, the LABO technique was performed in 107 patients. The principle is to use the lateral foreskin adjacent to the glans as the onlay flap. Patient age ranged between 8 months and 2 years (mean, 11 months). The records of 98 patients who maintained regular follow-up were reviewed. All the patients had proximal hypospadias with flat or incomplete cleft glans and did not have a deep chordee. Follow-up period ranged from 12 months to 8 years (mean, 32 months). A transurethral silastic catheter was used for 7 days.Results and ComplicationsSatisfactory results were obtained in 93 patients (95%). Two children developed fistula, 2 developed glans dehiscence, and 1 child had skin prolapsing from the meatus that required excision.ConclusionsThe LABO technique is a reliable technique for patients with proximal hypospadias in the absence of a deep chordee. It has particular value in patients with small or flat glans. With multiple layer closure and careful attention to technical details, a low complication rate (5%) was achieved in correcting this type of proximal hypospadias.