RESUMO
Objective: To investigate the effect of the application of scrotal midline raphe flaps in surgical repair of hypospadias with penile skin defects. METHODS: We retrospectively analyzed the clinical data on 20 cases of hypospadias with penile skin defects from January 2017 to July 2019. The patients ranged in age from 3 to 12 (mean 6.5) years, with a history of 0ï¼4 (mean 2.4) times of penile surgery. The urethral orifice was located in the midshaft of the penis or perineum, without urethral fistula or narrowing of the outer urethral orifice. We performed ubularized incised plate (TIP) repair of the penile skin defects with scrotal midline raphe flaps and followed up the patients for 7ï¼30 (mean 18.4) months postoperatively. RESULTS: The flaps survived well without necrosis in all the cases, and 18 (90%) of the cases were cured in the first stage. Two of the patients developed urethral fistula after removal of the catheter, which was successfully repaired at 6 months after the first operation. All the patients achieved smooth urination with no urethral stricture. The urinary flow rate was 5ï¼9 (mean 6.5) ml/s at 6 months postoperatively. All were satisfied with the appearance of the penis and scrotum. CONCLUSIONS: The scrotal midline raphe flap, with rich blood supply and good ductility, is suitable for repair of penile skin defects. And TIP repair with the scrotal midline raphe flap, with the advantages of simple operation, few complications and good appearance of the penis and scrotum, is worthy of clinical application.
