Outcomes of Two-Staged Repair Procedures for Adult Penoscrotal Hypospadias: A Retrospective Analysis.

OBJECTIVE: This study aimed to describe a two-stage repair technique (buccal mucosal grafting in Stage 1 and tunica vaginalis flap in Stage 2) and to evaluate its outcomes. METHODS: Ten cases of penoscrotal hypospadias with ventral chordee in adults were treated with two-stage repair (Group 1). Chordae correction was done in the first stage, a thin and unhealthy urethral plate was excised, and a buccal mucosal graft of 3-4 cm width was placed. The second stage was undertaken after three months, in which the neourethra was tabularized over a 14-Fr silicone catheter with the tunica vaginalis flap as the subsequent layer. Foley removal was done on postoperative day 5. The outcomes were compared with single-stage repair (Group 2) (n = 10) cases. RESULTS: While six cases had an excellent outcome in Group 1, only three had success in Group 2. Only one patient in Group 1 developed a urethrocutaneous fistula (UCF); Group 2 had five patients with UCF. In Group 1, one patient developed an infection with complete suture line disruption, and Group 2 had three cases each of wound infection and wound dehiscence. One patient in Group 1 and two in Group 2 developed superficial glans necrosis. The two-stage repair has a higher success rate than the single-stage repair (60% vs. 30%). CONCLUSION: Staged repair and use of 14-Fr Foley and early Foley catheter removal improve adult penoscrotal hypospadias repair outcomes.