Objective: To use the prepuce for double functions one as a second layer for the neourethra to decrease the
incidence of urethrocutaneous fistula and the second as a skin covering for the ventral aspect of the penis.
Material and methods: From January 2013 to December 2016, 37 cases of hypospadias with mild to moderate
chordee were included in this study. The cases with ventral penile skin defect were managed by tubularized
incised plate urethroplasty (TIPU) using pedicled preputial flap. Recurrent cases, cases with severe
chordee which necessitated division of the urethral plate, and cases with penoscrotal hypospadias were
excluded from this study.
Results: Thirty-seven cases of hypospadias aged 9-60 months with a mean age of 24.8 months were included
in this study. Coronal (n= 9 cases; 24.3%), distal penile (n=11; 29.9%), and midpenile hypospadias (n=
17; 45.9%) were detected in respective number of patients. Postoperative complications consisted of external
meatal stenosis (n=2; 8.1%), and one case with urethrocutaneous fistula. Skin necrosis was not reported in
this study. Follow-up visits were performed at 1, 3 and 6 months which showed good cosmetic appearance
that was accepted by their parents.
Conclusion: This technique was beneficial in decreasing the rate of skin necrosis, as it keeps the blood supply
to the preputial skin intact, and decreases the incidence of urethrocutaneous fistula.