Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Hypospadias is the third most prevalent congenital abnormality, with an occurrence rate of 3‐4 per 1000 live births. Proximal hypospadias with chordee is the most complex form to surgically repair. Despite numerous documented surgical procedures, there is ongoing debate regarding the most effective method for managing severe hypospadias. While Single stage repair has demonstrated efficacy in certain cases, a staged approach is often preferred for cases with severe chordee to ensure sufficient straightening and lengthening of the penis. We conducted a study at our center from 2019‐2024, including 50 patients with proximal penile hypospadias and severe chordee, some of whom also had other associated congenital problems. Data collected includes patients age at operation, degree of chordee, complications and cosmetic outcomes. All patients underwent staged Bayar's flap surgery. The first stage involved chordee release and Bayar's flap mobilization, followed by urethroplasty in the second stage after 6‐18 months. Patients were followed up for a minimum of one year after the second stage. The age group of 1.5‐5 years had the highest number of patients (28), followed by the 5‐10 years group (14) and the 10‐15 years group (8). Among the 50 patients, 38 had proximal penile hypospadias, 10 had penoscrotal hypospadias, and 2 had scrotal hypospadias. Complications included urethro‐cuteaneous fistula (5 patients), meatal stenosis (1 patient) and glans dehiscence (3 patients). There were no cases of complete disruption of repair, epididymitis orchitis, recurrence of chordee, or flap necrosis. The two‐stage procedure using Bayar's technique is a challenging but effective approach for proximal hypospadias. It reduces the rate of fistula formation, disruption, and stenosis and provides satisfactory cosmetic results. The success of the repair heavily depends on the accurate measurement of the urethral strip in the second stage, with all surgeries performed by a single surgeon.
How to cite this article:
Pankaj Shastri and Advait Prakash. Two Stage Bayar’s Flap Technique in Proximal Penile Hypospadias: Retrospective Study.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.8.536.540
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.8.536.540