[Surgical correction of hypospadias using a vascularized onlay flap].

The principle of the onlay technique is to create a neourethra from the preserved urethral plate to which the vascularized flap of the prepuce is applied. Thus 51 patients were operated 10 months to 27 years old, half of them were under 5 years. By this method hypospadias was treated from coronary to perineal ones. In 16 patients chordectomy was performed, in 6 plications of the cavernous bodies because of their disproportion of the ventral and dorsal side. In three instances it was necessary to transsection the urethral plate and supplement the onlay flap by tubulization of the neourethra. The method was also used in secondary strictures of the urethra after urethroplasty and in occlusions of a fistula. Complications of the neourethra were recorded in 4 (7.8%) patients. Another four patients had a partial necrosis of the skin cover. The onlay method is becoming universal for resolving the proximal variant of hypospadias, it is associated with a considerably smaller number of complications than tubulized plastic operations and makes possible a definite one-stage solution already at an early age.