Operative techniques and long-term outcomes of hypospadias repair in the absence of preputial skin after neonatal circumcision

Parents of children born with hypospadias are counseled to refrain from performance of neonatal circumcision with the intent of preserving the foreskin for later reconstructive efforts. In the past, several techniques of hypospadias reconstruction, such as preputial island tube and preputial onlay flap, have based the urethroplasty on preputial skin. Recent years have witnessed a shift to other techniques, such as tubularized incised plate urethroplasty (TIPU), which avoid the use of skin as a tissue source for urethroplasty in preference for the urethral plate [1,2].