Urologist's perspectives of single-stage hypospadias repair in the 1980s. Experience of 100 patients.

During the last two decades major advances have been made in techniques of hypospadias repair. Many areas warrant meticulous attention to achieve further satisfactory results. We present areas of technique that have improved our results in genital reconstruction and hypospadias repair in particular. In addition to surgical technique modifications, we present technical refinements of patient positioning, use of cold antibiotic mixed saline, subcutaneous epinephrine at judicious sites, and microsurgical instruments as well as optical magnification and suture material. In genital anomalies, use of plastic surgical techniques with skin grafts and knowledge of the intrinsic vascular supply of the foreskin have further improved the outcome. Since 1982, 100 patients have been followed. Immediate complications total less than 1 percent; late complications total 10 percent including 9 percent fistula rate and 5 percent stenosis rate (urethral or meatal). No loss of skin flap or of neourethra were recorded.