THE OUTCOME OF LONGITUDINAL DORSAL ISLAND FLAP FOR REPAIR OF HYPOSPADIAS IN CIRCUMCISED PATIENTS AND THOSE WITH FAILED PREVIOUS REPAIR

Abstract

THE OUTCOME OF LONGITUDINAL DORSAL ISLAND FLAP FOR REPAIR OF HYPOSPADIAS IN CIRCUMCISED PATIENTS AND THOSE WITH FAILED PREVIOUS REPAIR Majed Asgar Mohammad*, Firas Shakir Attar@, & Khaldon Sadek Alkhateep#. *,@ MB,ChB, FIBMS, Assistant Professors of urology at Basrah College of Medicine, University of Basrah, Consultant Urologists at Basrah Teaching Hospital, Basrah. #MB,ChB, FIBMS, Specialist Urologist at Al-Mawani General Hospital, Basrah, IRAQ.Abstract Patients with penoscrotal, proximal shaft and mid shaft hypospadias who were previously circumcised or patients with insufficient urethral plate such as those with severe chordee that cannot be corrected just by simple degloving, or failure of previous hypospadias repair, such patients represent a challenge for subsequent repair and appropriate procedure choice. The aim of this study is to assess the outcome of longitudinal dorsal island flap (LDIF) by both onlay and tubularized repair for patients with hypospadias who were previously circumcised or had poorly developed urethral plate. This prospective study was done on 36 patients who had penoscrotal, proximal and mid shaft hypospadias and were previously circumcised or had poorly developed urethral plate. Twenty four of them were operated upon by using onlay LDIF and 12 patients by using tubularized LDIF. Patients were followed-up for 12 months to look for any complication for these 2 types of surgeries and for assessing the functional outcome of the repair. The success rate for onlay LIDF was 75% and for tubularized LIDF was 58.33%. Overall complications occurred in 11 (30.55%) children. In conclusion, LDIF can be used successfully for repair of hypospadias in circumcised children or those with failed previous repair.Keywords: Hypospadias, LDIF, failed repair, tabularized incised plate urethroplasty