Comparison of Outcome and Success Rate of Onlay Island Flap and Dorsal Inlay Graft in Hypospadias Reconstruction: A Prospective Study

Figures & data

Figure 1 Island onlay flap technique. (A) Patient pre-operative proximal hypospadias clinical appearance. (B) Surgical site marking on the patient penis. (C) Post-operative clinical appearance of patient. (D) One-month post-operative follow-up of the patient.

Table 1 Subjects Characteristics

Variables	Onlay Island Flap (n=35; 59.3%)	Dorsal Inlay Graft (n=24; 40.7%)	Total (n=59; 100%)	P-value
Age	4.0 (1–67)	7.50 (1–26)	4.0 (1.0–67.0)
Chordee Severity
None-to-Mild	3 (8.6%)	4 (16.7)	7 (11.9)	0.002
Moderate	21 (60%)	9 (37.5)	30 (50.8)
Severe	11 (31.4)	11 (45.8)	22 (37.3)
Urethral Plate Size
Narrow	17 (48.6)	11 (45.8)	28 (47.5)	0.839
Wide	18 (51.4)	13 (54.2)	31 (52.5)
Type of Hypospadias
Anterior	11 (31.4)	6 (25)	17 (28.8)	0.694
Middle	9 (25.7)	5 (20.8)	14 (23.7)
Posterior	15 (42.9)	13 (53.2)	28 (47.5)

Notes: P<0.002. There is a significantly statistical difference between the two groups.

Table 2 Outcome Comparison Between Onlay Island Flap and Dorsal Inlay Graft

Outcome Variables	Onlay Island Flap	Dorsal Inlay Graft	P-value
Patient Satisfaction
Meatal Shape and Position
Very Dissatisfied	0 (0)	0 (0)	0.618
Dissatisfied	4 (11.4)	4 (16.7)
Satisfied	22 (62.9)	15 (62.5)
Very Satisfied	9 (25.7)	5 (20.8)
Glands Shape
Very Dissatisfied	0 (0)	1 (4.2)	0.324
Dissatisfied	2 (5.7)	3 (12.5)
Satisfied	23 (65.7)	14 (58.3)
Very Satisfied	10 (28.6)	7 (29.2)
Penile Skin Shape
Very Dissatisfied	0 (0)	0 (0)	0.489
Dissatisfied	4 (11.4)	2 (8.3) 16
Satisfied	23 (65.7)	(66.7)
Very Satisfied	8 (22.9)	6 (25)
General Cosmetic Appearance
Very Dissatisfied	0 (0)	0 (0)	0.526
Dissatisfied	5 (14.3)	3 (12.5)
Satisfied	25 (71.5)	15 (62.5)
Very Satisfied	5 (14.3)	6 (25)
Complication Occurrence
Yes	4 (11.4)	5 (20.8)	0.464
No	31 (88.6)	19 (79.2)
Time to Complication
Median Months (Min-Max)	19 (10–28)	14 (6–21)	0.413

Table 3 Uroflowmetry Outcome, Operation Time, and Duration of Catheterization Comparison Between Onlay Island Flap and Dorsal Inlay Graft

Outcome Variable	Onlay Island Flap	Dorsal Inlay Graft	P-value
Uroflowmetry Result
Qmax	6.2 (4.2–22.4)	10.1 (4.8–22.8)	0.125
Qmean	3.9 (2.4–12.1)	5.1 (3–13)	0.136
Voided volume	48 (28–247)	64 (33–337)	0.076
PVR	2 (0–26.9)	2.7 (0–25.7)	0.260
Operation Time
Mean of operation time (minutes)	169.2±28.6	254.4±40.1	<0.001
Duration of Catheterization
Mean of duration of catheterization (minutes)	5.3±0.6	7.1±0.3	<0.001

Notes: P<0.001. There is significant statistical difference between two groups.