Hypospadias repair: the two‐stage alternative

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Summary: One‐stage repairs for hypospadias are attractive in concept and are currently in vogue, but many surgeons remain unhappy with their inherent limitations and drawbacks. Two‐stage repair, reconstructing the new urethra with a full‐thickness skin graft, offers a realistic alternative and the method described here can be applied to almost any degree of deformity, be it a simple primary case or salvage of a multi‐operated and skin‐deficient hypospadias ‘cripple’. From a personal series of over 600 cases the author concludes that a two‐stage operation is an acceptable price to pay for a repair that offers unique versatility, excellent reliability and a sophistication of function and aesthetics thatis hard to achieve with one‐stage methods.

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