Kamil Javorka, Igor Sopilko, Juraj Svitač
Introduction: Onlay technique utilises prepucial patch which is attached to urethral plate to form neourethra. The aim of hypospadias surgery is to achieve a normal function and cosmetic appearance of the penis. The aim of our retrospective study was to summarize our experience with this method. Material and methods: 28 patients (age 20 months – 37 years, follow-up 6 months – 6 years) with hypospadias after Onlay between January 2002 to December 2007 were analyzed retrospectively (19 primary surgery, 9 re-operations). Onlay was indicated in 28 patients from which 16 patients (57.1 %) with distal hypospadia, 12 patients (42.9 %) with proximal form of hypospadia. Silicone urethral stent was used in 28 (100 %) patients, derivation by suprapubic tube remained for a period of 14 days. Straightening of the penis was necessary in 21 patients (75.0 %), dorsal medial plication in 8 (38.1 %), combination of dorsal medial plication and straightening by Nesbit in 6 (28.6 %), Nesbit alone in 7 (33.3 %) patients. Results: Surgery without complications was in 22 (78.6 %), urethrocutaneous fistula occurred in 3 (10.7 %), glandular dehiscence in 2 (7.2 %), meatal stenosis in 1 (3.6 %) patients. The successful occlusion of urethrocutaneous fistula was performed in 2 patients 10 to 14 months following primary surgery. One fistula healed spontaneously 3 months after surgery. Two patients with glandular dehiscence had primary surgery for penoscrotal hypospadias. They both had improved cosmetic results following the surgery despite the complications and were reluctant to further repair. Meatal stenosis in 1 patient was resolved by ventral meatotomy 2 months after surgery. Conclusion: Onlay technique offers very good cosmetic and functional results.