Özet:

Abstract Purpose Surgical management for the level proximal hypospadias remains controversial and it might be challenging. In this study, we evaluated the surgical outcome of patients with proximal hypospadias managed by two stages of repair with dorsal prepucial flaps. Patients and Methods Forty one boys with proximal hypospadias are registered between January 2006 and September 2016. The location of the urethral meatus was at the penoscrotal junction (PSH), at the scrotum (SH) or at the perineum (PRH). First stage; chordee was released and the prepucial flaps were constructed. Second stage; urethroplasty was performed according to the Thiersch-Duplay principle. We assessed postoperative complication rates and used Hypospadias Objective Penile Evaluation (HOPE) scoring to evaluate the cosmetic outcome. Results There are a total of 41 boys (31 PSH(%76), 3 SH(%7) and 7 PRH(%17). The average age at the first operation was 15±5.3 months. The average interval between the stages of the surgical procedures was 10.1±4.9months. Sixteen patients had various enzyme deficiency or dysgenesis. In two patients, diverticulum is developed after the repair. Stenosis has encountered in 10 patients and fistula in 5. Two patients had dehiscence at glanular level. The relationship was not demonstrated between the severity of hypospadias and development of fistula, stricture and diverticulum (p>0,05). HOPE scores; 9.4 for the position of the meatus, 5.8 for shape of the meatus, 7.2 for shape of the glans penis, 9.3 for penile torsion and 9.8 penile curvature.  Conclusion Incorporating the dorsal prepucial skin flaps in staged procedures has both satisfactory cosmetic and functional success rates.

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