[A single-stage reconstruction in hypospadias using a vascularized preputial flap].

The authors submit an account of their experience with a modern method of reconstruction of hypospadias connected with the chorda. In 31 boys (10 months to 15 years) they used for reconstruction of the urethra a flap from the prepuce with a preserved vascular stalk, as described by Duckett. In the majority they transferred a double flap ("double face") where the outer sheath of the prepuce was used to cover the ventral side of the penis. In three boys the authors performed their own modification of this plastic operation. Complications developed in 12 boys (38.7%): stricture of the proximal anastomosis of the urethra (6), stricture of the meatus (1), necrosis of the skin cover (4), dehiscence (1). An open operation had to be made in the last five patients (16.1%). In all children excellent functional and aesthetic results were achieved. The above plastic operation is indicated in penile and penoscrotal hypospadias with chorda. It is a single stage operation. Due to the use of vascularized tissue and the microsurgical technique it is possible to perform a definite reconstruction of the external genitalia already by the age of one year.