Results of surgical treatment of proximal hypospadias

Eighteen patients of proximal hypospadia underwent operations by our two-stage method. First stage operation was done by exaggerated Nesbit's method. The foreskin was transposed to the ventral surface of the penis as a flap that is long enough to be brought to the top of the glans. The second-stage procedure was done after a minimum of 6 months. The urethral tube was formed around the Foley catheter with a flap, its peripheral end being one to two centimeters proximal to the sulcus. For one to two centimeters the distal flap was freed. The tubularization was done by a continuous 4-0 nylon suture, which was removed after ten days. The tube was passed to the top of the glans through the tunnel and sutured to the glans with 5-0 nylon. Urinary diversion was not performed. In one case the new urethral orifice receded and reoperation was done. The operations in the other 17 cases were successful without stricture or fistula formation.