Total Preputial Flap: A Reliable and Versatile Technique for Urethral and Penile Reconstruction

Ludwikowski, Barbara; González, Ricardo

doi:10.3389/fped.2014.00043

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…ey adopted different techniques for urethroplasty [tubularized incised plate (TIP), preputial flap as onlay, or tubularized (Duckett)]. e median HOSE score was 14 (11)(12)(13)(14)(15)(16). ere was no difference in HOSE between patients undergoing a TIP, onlay, or Duckett procedure [25].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett’s Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study

Shahin

Abdalrazek

Abdelmaboud

et al. 2022

Advances in Urology

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Background. Proximal hypospadias, with significant curvature, is one of the most challenging anomalies. Great diversity and a large number of procedures described over the last 4 decades confirmed the fact that no single procedure has been universally accepted or successful. So, the aim of this study is to evaluate double-faced tubularized preputial flap (DFPF) versus transverse tubularized inner preputial flap (Duckett’s procedure) as regards surgical outcomes, complications rate, and cosmetic results for repair of penoscrotal hypospadias with chordee. Patients and Methods. This was a prospective comparative study on 144 children with primary penoscrotal hypospadias with moderate or severe chordee, conducted at New Damietta and Assuit hospitals, Al-Azhar University, from March 2016 to March 2022. The patients were randomly divided into two equal groups; group A (n = 72) underwent DFPF, and group B (n = 72) underwent Duckett’s procedure. Results. No significant difference was identified as regards demographic data. The follow-up period ranged from 20 to 66 months (mean of 28 months after DFPF and 31 months after Duckett’s repair), and the complication rate was 20.1% (29 of 144 children). There were statistically significant differences between the two groups as regards the urethral stricture, penile rotation, and total complication rate. HOSE score was adopted for assessment of surgical outcomes, urine stream, and cosmetic results. Conclusions. The DFPF technique is feasible and reliable for one-stage repair of penoscrotal hypospadias with chordee and can be considered as a good option as it ensures better surgical and cosmetic outcomes with lower incidence of complications.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett’s Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study

Shahin

Abdalrazek

Abdelmaboud

et al. 2022

Advances in Urology

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“…Classically, the onlay has been constructed with the inner layer of the prepuce ( 24 ) leaving the outer layer, which may be needed to cover the penile shaft (usually as rotational Byars flaps ( 25 )) with poor blood supply ( 26 ). In contrast, the use of the TPF ( 16 ) ensures that both the skin used for the onlay and the skin use for ventral coverage preserve excellent blood supply. The ventral transposition using a buttonhole at the base of the pedicle prevents axial rotation of the penis, an undesirable outcome that can be seen when the pedicle is brought along a side of the shaft ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…When the ventral skin deficiency required it, a double face preputial flap was used. All flaps were prepared using the TPF technique and were transferred ventrally by creating a buttonhole in its pedicle to avoid penile rotation ( 16 ) Exclusion criteria: previous circumcision or operation for correction of hypospadias. Demographic data, duration of follow-up, complications, and reoperations were recorded.…”

Section: Methodsmentioning

confidence: 99%

“…A TPF is now prepared as previously described ( 16 ). The flap is transposed ventrally and rotated 90° (Figure 7 ).…”

Section: Methodsmentioning

confidence: 99%

“…Nevertheless, based on our previous experience and given the fact that some literature reports equivalent results with various techniques, we have continued to use the technique described by one of us more than 20 years ago ( 15 ), which consists of avoiding the division of the urethral plate in the majority of the cases and reconstruction of the urethra with an onlay flap derived from the outer layer of a total preputial flap (TPF) and when the ventral skin deficiency required it, a double face preputial flap was used ( 16 ). Onlay urethroplasty for the repair of hypospadias has yielded good long-term results ( 10 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

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Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias

2018

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AimsTo report current results of preputial flap onlay urethroplasty using the principle of the total preputial flap (TPF) for the one-stage repair of mid- and proximal hypospadias.MethodsThis study was a retrospective chart review of patients in a prospectively kept database of all hypospadias operations performed at two institutions from January 1 2011 to August 2017. Inclusion criteria: all patients who underwent hypospadias repair using a preputial only flap urethroplasty based on the principle of the TPF. Demographic data, duration of follow-up, complications, and reoperations were recorded. A successful result was considered to be a straight penis, a glanular meatus, and absence of voiding symptoms. Whenever possible an uroflow was obtained during the follow-up visits.ResultsForty-nine children met the inclusion criteria. All patients had marked penile curvature. Three patients had chromosomal abnormalities. The mean age at the time of surgery was 22 months (11–110) and the mean duration of follow-up 23.4 months (1–79). In 48 cases, the urethral plate could be preserved without dividing it. The penile curvature was corrected with chordectomy alone in 10 patients, 38 required a dorsal plication of the tunica albuginea, and 1 required an additional ventral dermal graft. In 38 patients (77.5%), the initial operation was successful, and no further operations were needed. There were eight urethrocutaneous fistulas, three dehiscences of the glans approximation. One patient suffered a wound infection and partial loss of the flap.ConclusionOne-stage repair of mid- and proximal hypospadias preserving the urethral plate and using a TPF for the urethroplasty and coverage of the ventral penis is successful in 77.5% of cases. Complications in the remaining patients were easily managed or did not require treatment. Compared to a planned two-stage approach, the technique described in this report resulted in significantly fewer procedures till complete resolution of the problem.

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Evaluation of Double Face Preputial Flap for Management of Hypospadias in Children

Radwan

Desoky

Shabaan

2019

The Egyptian Journal of Hospital Medicine

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Total Preputial Flap: A Reliable and Versatile Technique for Urethral and Penile Reconstruction

Cited by 4 publications

References 13 publications

Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett’s Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study

Evaluation of Double-Faced Tubularized Preputial Flap versus Duckett’s Procedure for Repair of Penoscrotal Hypospadias with Significant Penile Curvature: A Comparative Study

Results of Onlay Preputial Flap Urethroplasty for the Single-Stage Repair of Mid- and Proximal Hypospadias

Evaluation of Double Face Preputial Flap for Management of Hypospadias in Children

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