Can a slit-like meatus be achieved with the V-incision sutured meatoplasty for onlay island flap hypospadias repair?


Yutaro Hayashi, Nagoya City University, Graduate School of Medical Sciences, Nephro-Urology, Nagoya, Japan.


In the paediatric urology section this month, the papers describe studies on hypospadias repair and renal function after pyeloplasty.


To evaluate whether the V-incision sutured meatoplasty (VSM) is useful for configuring the constructed meatus after the onlay flap and the Mathieu flip-flap repair for hypospadias, as the transverse preputial onlay island urethroplasty is excellent for repairing anterior hypospadias with no chordee, and a slit-like normal meatus cannot be constructed in many patients who had the original onlay island-flap repair


The configuration of the meatus which was repaired by the onlay island flap technique with VSM (group 2) was evaluated and compared with that of the original onlay technique (group 1). Group 1 consisted of 30 patients treated with only the classic onlay procedure as primary hypospadias repair (1999–2001). Group 2 consisted of 22 patients treated using the onlay procedure with VSM as primary hypospadias repair (2002–2004).


There were complications after surgery in four (18%) of 22 patients in group 1 and in five (17%) of 30 in group 2, with no significant difference. A slit-like meatus was achieved in eight (27%) of 30 in group 1 and in 12 (55%) of 22 in group 2. There was a significant difference between the groups in meatal configuration (P = 0.04).


The VSM is a useful technique to make a slit-like meatus for onlay island flap urethroplasty and flip-flap hypospadias repair, although the technique cannot always achieve the intended result.