Lateral-based flap: a single stage urethral reconstruction for proximal hypospadias

PurposeThe aim of this study is to describe and report the outcome of a single stage repair—the lateral-based (LB) flap—for proximal hypospadias with chordee.Materials and MethodsBetween January 1995 and January 2007, 107 boys with proximal hypospadias underwent repair using the LB flap technique. The boys' age ranged from 1 to 5 years. The technique employs the use of lateral penile skin and extends into the outer preputial skin. The LB flap enjoys double blood supply from the base of the meatus as well as the preputial vessels. The Y-shaped incision in the glans gives a terminal slit-like meatus, and the technique allows for correction of the chordee. Follow-up period ranged from 1 year to 13 years (mean, 72 months).Results and ComplicationsSatisfactory results were obtained in 98 (91%) patients. Three patients developed fistulae. Two patients had proximal stenosis that required temporary urethrotomy for 3 months. Four patients developed urethral diverticulum.ConclusionsThe LB flap is a robust flap with a reliable dual blood supply, which produces good results (91%) and is suitable for proximal forms of hypospadias with chordee.