Objective To summarize the experiences of hypospadias repair using prolonged and broadened plate plus Onlay flap urethroplasty.Methods A retrospective review of prolonged and broadened plate plus Onlay flap urethroplasty was performed from October 2015 to April 2016.Among 37 patients with primary hypospadias,the clinical types were penile (n =27) and penoscrotal (n =10).Urethral plate was resected for straightening out corpora cavernosa.All urethral plates measured ≥8 mm and all glans ≥14 mm in diameter.Urethral plate was preserved and penile skin degloved until root of penis.After fully straightening out,lengthway incision was made in the middle of urethral plate for broadening.Then sideling in the most obvious place of penis was bent for prolonging urethral plate.After indwelling catheter,partial urethra formed.Then a foreskin pedicel island flap was chipped and onlaid with urethral plate.Ventral superficial fascia was used as a second layer vascular cover over neourethra.Glansplasty was performed with suturing glans wings to obtain the esthetics of glans and meatus.Results All operations were performed successfully.The average operative duration was 77 (65-95) min.The postoperative complications included urethral fistula (n =4,10.8％)and urethral stricture (n=5,13.5％).All 5 patients stayed in remission after 1-3 urethra dilatation.After a 3-month follow-up period,3 cases (8.1％) were complicated by urethral fistula.There was no occurrence of urethral stricture or recurrent penile curvature.All of them had entopic and slitlike urinary meatus.Conclusions Prolonged and broadened plate plus Onlay flap urethroplasty is effective for severe hypospadias.With a low incidence of postoperative complications,this procedure may be easily performed.It is indicated when transecting urethral plate is required for penile straightening.

Objective To summarize the experience of hypospadias repair with tubularized incision and prolonged plate urethroplasty.Methods From June 2015 to November 2015,a retrospective review of tubularized incision and prolonged plate urethroplasty was performed for 21 primary hypospadias patients.The clinical types were penile (n =17) and penoscrotal (n =4).After reserving urethral plate and degloving penile skin to penile root,full straightening out was performed.Incision of middle urethral plate was intended for broadening urethral plate.And sideway incision in the most obvious bent place of penis was made to prolong urethral plate.After indwelling catheter,urethra was formed.Results The average operative duration was 78 (65-100) min.Postoperative complications included urethral fistula (n =3,14.3％) and urethral stricture (n =4,19.0％).All of them stayed in remission after 1-3 sessions of urethra dilatation.During a follow-up period of 3 months,2 cases (9.5％) were complicated by urethral fistula.There was no instance of urethral stricture or recurrent penile curvature.Conclusions Tubularized incision and prolonged plate urethroplasty are effective for hypospadias.With a low incidence of postoperative complications,this procedure may be easily popularized at grass-roots.

Objective To evaluate the outcomes of penoplasty with penile frenulum lengthening for concealed penis in children.Methods From March 2014 to March 2016,a total of 233 patients with concealed penis who enderwent penoplasty with penile frenulum lengthening were enrolled.The everage age at surgery was 3.7 years (1 year and seven months-12 years).There were 73 cases with obvious small urinary stream,dysuria,or prepuce dilatation when urinating;41 cases with the history of recurrent infections of prepuces;and 9 cases with the history of urinary tract infections.During operation,incise the back side center of the outer plate of the prepuce and fully release the ring-type funicular tissue between the inner and outer plates of the prepuce to make the inner plate fully swell out.After the prepuce is upturned,cut the penile frenulum at the coronary sulcus.Make a "V-shaped" cut on the left and right sides of the far end of the outer plate cut of the prepuce from the cut of the penile frenulum.Lengthen penile frenulum after the prepuce is pressed off.Cover the dorsal side of the penis with the inner plate of the prepuce and cover its ventral side with its outer plate.Results Mean surgical time for patients was 38 min (30-55 min).All operations were completed successfully and the post-operation follow-up lasts 3 months to 2 years.For all cases,the appearance of the penis is improved.The penis stretches out,the balanus is exposed,the prepuce has no obvious swelling and the scrotum angle of the penis is obvious.No phimosis relapses and there is no obvious scar hyperplasia.Conclusions This surgical procedure is an effective treatment choice for concealed penis.It provides a good cosmetic result.