Balanic groove and urethral plate mobilization for repair of hypospadias: a modified Barcat technique

ABSTRACT

This work was done on 72 boys with distal hypospadias. They were glanular in 21 cases, coronal and subcoronal in 38 and anterior penile hypospadias in 13 patients. The recurrent cases were 24. The follow up period averaged 48 months. The study aimed to evaluate Barcat technique, which uses apposing fully mobilized and vascularized meatal skin flaps with some modifications [lateral tissue cover and closure of the divergent remnant of distal corpus spongiosum] for the repair of distal hypospadias. The results were satisfactory; about 95% of the patients had an excellent cosmetic and functional outcome, the meatus at the tip of the glans, no evidence of significant chordee and no penile skin problem. The fistulae occurred in two patients with coronal and subcoronal type [one of them underwent previous repair] and in three patients with anterior penile hypospadias [two of them underwent previous repair]. Re-operation occurred in three patients, two of them underwent previous hypospadias repair. This technique allows anatomically superior glans reconstruction in distal hypospadias and the fistula rates can be reduced by tissue coverage of the neourethra