Prevention of meatal stenosis with W-flap glanuloplasty in hypospadias surgery: a long-term follow-up

Ann Plast Surg. 2000 Jul;45(1):37-41. doi: 10.1097/00000637-200045010-00007.

Abstract

Meatal stenosis is a complication that can occur after hypospadias surgery. Although there are many different surgical techniques that can solve this problem, once it has occurred, meatal stenosis can be difficult to treat. To decrease meatal stenosis risk and to achieve an anatomically placed, aesthetically pleasing meatal opening, a new W flap was designed for glanuloplasty. The authors describe the technique in detail along with long-term results. A total of 356 hypospadias cases were operated using various urethroplasty methods. Independent from the preferred urethroplasty method, the W-flap was used for glanuloplasty in all patients. Patients were followed for 1 to 10 years. Meatal stenosis incidence was 0.8%, and good cosmetic results with a natural-looking, anatomically placed meatus and a well-directed urinary stream during urination were achieved. W-flap glanuloplasty, an addition to reconstructive surgeons' armamentarium, is applicable to most patients. It places the meatus in its appropriate anatomic location, increases the meatal diameter by insetting two flaps, avoids a circular anastomosis, reduces the risk of late contraction, helps to achieve good aesthetic results with good urinary stream, eliminates the need for stents, and reduces meatal stenosis risk overall. It is a good glanuloplasty alternative that can be applied with most hypospadias repair techniques.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Hypospadias / surgery*
  • Male
  • Postoperative Complications / prevention & control*
  • Surgical Flaps*
  • Time Factors
  • Urethral Stricture / prevention & control*
  • Urologic Surgical Procedures, Male / methods