A boy with severe hypospadias – Transverse Island Onlay Flap urethroplasty

S.J., an 8-month-old baby, was brought to Dr. A.K. Singal’s Hypospadias clinic with an abnormal-looking penis and passage of urine from the underside of the penis, almost near the scrotum. On examination, he was diagnosed with a condition called Penoscrotal Hypospadias with mild chordee (an abnormality where the penis is bent downwards). The baby was planned for a corrective hypospadias surgery called SINGLE STAGE URETHROPLASTY, which can be done by multiple techniques, including the Transverse Island Onlay Flap urethroplasty. This technique is particularly suited for cases like a boy with severe hypospadias.

The exact technique in this case was a long Tranverse Island flap urethroplasty. This is the appropriate age (6-9 months) for such surgeries as the final results are very good both cosmetically and functionally at such a young age.

The baby was taken up for surgery and he required only one day stay in the hospital. The dressing was removed on day5 and the catheter on day12.

At 3 months follow-up he has a normal looking circumcised penis with a urethral opening at the top of the glans

Facts about Hypospadias

• Hypospadias is one of the most common pediatric urological anomalies worldwide.
• The correct age for hypospadias repair surgery is between 6-9 months.
• Most of the hypospadias can be corrected with a single stage surgery, rarely if the penis is too curved (chordee) or the skin is short or there is an associated disorder of sex development, a two or a three stage hypospdias repair may be required.
• The success rate of Single Stage Urethroplasty in correctly chosen cases is more than 95%.
• Most common problems after hypospadias surgery procedure (5%) are infection and formation of a urethral hypospadias fistula requiring a second surgery.