Objective: To summarize the experience in the surgical treatment of hypospadias by analyzing the operation features and clinical effects of two different routes for transferring the pedicled preputial island flap.
Methods: This retrospective study included 122 cases of hypospadias treated by transferring the pedicled preputial island flap, 80 from one side of the penis (the control group) and the other 42 through the middle orifice of the vascular pedicle (the observation group). We recorded the intra- and postoperative data and compared them between the two groups.
Results: The operation time was significantly longer in the observation group than in the control (［164.43 ± 25.03］ vs ［134.71 ± 32.37］ min, P < 0.01), but the catheter-indwelling time was dramatically shorter in the former than in the latter group (［2.93 ± 0.97］ vs ［3.68 ± 0.73］ wk, P < 0.01). There was no statistically significant difference in the length of the reconstructed urethra between the two groups (［2.86 ± 0.71］ vs ［2.83 ± 0.82］ cm, P = 0.863). A 6- to 12-month follow-up showed a significantly lower incidence of postoperative complications in the observation than in the control group (9.52% vs 25.00%, P < 0.05).
Conclusions: Transferring the pedicled preputial island flap through the middle orifice of the vascular pedicle, though taking a longer time than that from one side of the penis, has the advantages of a shorter catheter-indwelling time and a lower incidence rate of postoperative complications, and therefore deserves wide clinical application.
Keywords: pedicled preputial island flap; skin flap transfer; hypospadias.