Scrotal flaps for skin deficit correction after failed hypospadias repair.

PURPOSE: To analyze the effectiveness of scrotal flaps' use for skin deficit correction in re-operative cases to improve hypospadias' treatment results in children.

METHODS: In the Urology Department of the Russian Children's Clinical Hospital (from 2013 to 2019) 46 patients were treated with hypospadias who underwent 3 to 7 failed repairs before being admitted to the clinic. Patients were divided into two groups: Group I - 24 patients with ventral skin deficit and proximal hypospadias; Group II - 22 patients with circumferential skin deficit and mid-shaft hypospadias. Scrotal flaps were used in both groups to cover the skin defect. The results were analyzed in short- and long-term follow-up of 2-8 years. Cosmetic results according to Hypospadias Objective Penile Evaluation scale, as well as functional results (recovery of independent free urination, lack of complications) were assessed.

RESULTS: In long term follow-up, there is no statistically significant difference between Group I and Group II in number of fistulas and cases of glans dehiscence. Total number of complications in Group I - 6 (25%) vs 6 (27.3%) in Group II. Good cosmetic results were obtained in most patients of both groups, and satisfactory cosmetic results in 1 patient (4.1%) from Group I, and 2 patients (9.1%) from Group II (Table).

CONCLUSION: In re-operative cases of midshaft and proximal hypospadias repairs, scrotal flaps allow to obtain good cosmetic and functional results, correcting ventral and circumferential skin deficit.