A cover flap reduces the rate of fistula after urethroplasty whatever the severity of hypospadias

Objective To determine which patients should benefit from the interposition of a well-vascularized flap between the neourethra and the penile skin and if it should be performed even in mild hypospadias. Patients and methods A retrospective study on patients with a primary hypospadias repair was perf...

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Bibliographic Details
Published in:World journal of urology 2021-07, Vol.39 (7), p.2691-2695
Main Authors: Tessier, Benoit, Sfar, Sami, Garnier, Sarah, Coffy, Amandine, Borrego, Paula, Gaspari, Laura, Paris, Francoise, Kalfa, Nicolas
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Fistula
Fistula - epidemiology
Fistula - prevention & control
Fistulae
Human health and pathology
Humans
Hypospadias - surgery
Infant
Life Sciences
Male
Medicine
Medicine & Public Health
Nephrology
Oncology
Original Article
Patients
Penis
Phenotypes
Postoperative Complications - epidemiology
Postoperative Complications - prevention & control
Retrospective Studies
Severity of Illness Index
Surgical Flaps - blood supply
Urethra - surgery
Urologic Surgical Procedures, Male - methods
Urology
Urology and Nephrology
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Summary:Objective To determine which patients should benefit from the interposition of a well-vascularized flap between the neourethra and the penile skin and if it should be performed even in mild hypospadias. Patients and methods A retrospective study on patients with a primary hypospadias repair was performed (2003–2017). Only patients undergoing urethroplasty based on the principle of a tubularization were selected to ensure comparable groups. Patients were assigned in two groups according to the use or not of a cover flap. Univariate analysis and adjusted logistic regression were used to evaluate the relation between postoperative complications, the severity of hypospadias, the use of flap and patients’ characteristics. Results Three-hundred and seventy-six patients were included with anterior (59.3%), midshaft (27.4%) and posterior hypospadias (13.3%). The median follow-up was 54 months (24 months–17 years). The overall rate of fistula was 11.7% (n = 44). Comparing the outcome in children with flap ( n  = 217) to controls ( n  = 159) showed that the use of a flap reduces the rate of fistula (6.5 vs 18.9%, p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-020-03489-1