Reverse Tumble Flap with Tubed Island-Flap Urethroplasty for Hypospadias or Chordee Without Hypospadias

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Abstract
During an 8 yr period, 47 children who required detachment of the meatus from more distal tissues for adequate chordee release or who needed division of the urethra underwent a 1-stage tubed island-flap procedure. In this procedure, the dorsal surface of the hooded prepuce is used to form a urethral tube and the ventral surface is used for shaft skin coverage. In followup to 5 yr, the long-term functional and cosmetic results appear acceptable for situations requiring creation of only a moderate length of urethra. For more proximal hypospadias, a high complication rate has discouraged the continued use of this 1-stage procedure.

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