Vertical preputial flap with double skin island for correction of hypospadias with severe recurvatum.

Eight patients presenting with a proximal hypospadias and penis recurvatum have been operated on. A one-stage procedure, based on the vertical preputial island flap operation, was the option for surgery. To reconstruct the missing urethra and the ventral skin defect, after the correction of the curvature, a single flap carrying two skin islands, useful for both goals, was planned. The urethroplasty was performed using the dorsal aspect of the island flap, according to Scuderi's operation, and the skin defect was reconstructed by means of the ventral aspect. No postoperative complication occurred. In all patients it was possible to place the meatus at the apex of the glans and to reconstruct the ventral skin continuity. The use of the vertical, "double-face," preputial island flap technique is suggested for single-stage repair of proximal hypospadias with severe recurvatum, presenting long urethral and large ventral skin defects.