Evaluation of the Use of a Tubularized Vascularized Skin Flap from Dorsal Penile Skin with a Modification of Skin Covering for Proximal Hypospadias Cripples

Background: Surgical techniques to repair crippled hypospadias have undergone remarkable advances in recent years with the development and widespread use of dorsal penile skin to facilitate urethroplasty. Objective: To evaluate the use of tubularized vascularized skin flap from dorsal penile skin with a modification of skin covering in management of proximal hypospadias cripples. Patients and Methods: This study was carried out on 35 patients with crippled hypospadias, managed with tubularized vascularized skin flap from dorsal penile skin with a modification of skin covering at Al-Azhar university hospitals from November 2019 till May 2021. Results: Our experience with 35 cases of proximal crippled hypospadias shows that urethroplasty using tubularized skin flap from dorsal penile side with modification can be used as an alternative technique with low complication rate for repairing proximal crippled hypospadias. Conclusion: Repair of proximal crippled hypospadias carries a great challenge with large risk of subsequent complications. Redo repairs for recurrent hypospadias is associated with higher fistula and reoperation rates when compared to primary repairs for proximal hypospadias.