Repair of hypospadias fistula using a penile skin advancement flap with penile dartos interposition

ObjectiveWe aim to report a single surgeon's experience of using a penile skin advancement flap with penile dartos interposition for hypospadias fistula repair.Patients & methodsAll hypospadias fistula repairs performed in our unit by this paediatric urologist between 2000 and 2012 were identified from a prospectively recorded database. Patients' case-notes were reviewed retrospectively gathering data on surgical technique, post-operative care and fistula recurrence on follow-up. Only those boys having repair by this advancement flap technique were included. A urethral catheter was left in situ in all patients for 5-7 days. Repairs performed using other techniques were excluded.Results20 consecutive patients had fistula repair by the advancement flap technique. This was the primary repair in 19 boys, and was repair of a third fistula occurrence in one. The median age at fistula repair was 3.7 years (1.6-15.3). The median follow-up was 4 months (3-73). One boy failed to attend any follow-up. No recurrence has yet been identified in any of the 20 patients.ConclusionThe penile skin advancement flap with dartos interposition technique was very successful in our series in both primary fistula repair, and in a patient who had multiple previous operations.