TRANSVERSE PREPUTIAL ISLAND PEDICLE FLAP (TPIPF) IN TREATMENT OF FAILED HYPOSPADIAS REPAIR: PERSONAL EXPERIENCE

Abstract

This is a study to review the local experience with the use of TPIPF in the repair of failed hypospadias in order to improve the results in the future. A total Number of 20 cases of failed Hypospadias was repaired during the period between 2001-2009 done in the public and private hospitals in Tikrit and Basrah. The repair was accomplished via Duckett method (transverse preputial island pedicle flap). The medical and operative records of each patient were registered and followed for 6 months. The success rate was 47% (9 patients). The complication rate was 55% in which urethro-cutaneous fistula was the commonest in 32% of the cases, meatal stenosis in 16%, urethral stricture in 10% and breakdown of the tube in 5%. In conclusion, TPIPF remains a viable option in the management of failed hypospadias especially in the proximal type, the complications can be avoided by using the magnification loupes with perfect surgical technique and mandatory proximal urinary diversion.