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J Pediatr Urol. 2014 Apr;10(2):399.e1-2. doi: 10.1016/j.jpurol.2013.10.022. Epub 2013 Nov 21.

Isolated preputial reconstruction in distal hypospadias.

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  • 1Royal Devon and Exeter NHS Foundation Trust, UK.
  • 2Department of Paediatric Urology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol¬†BS2 8BJ, UK. Electronic address:



The aim of this single centre study was to determine: a) the outcome of isolated preputial reconstruction in distal hypospadias and b) overall parental satisfaction.


A retrospective analysis of case notes was performed to determine outcome. Postal parent-satisfaction questionnaires were devised to quantify subjective assessment of care and outcome.


A total of 33 cases of isolated preputial reconstruction were identified between 2006 and 2012. Three sets of notes were untraceable. The median age of the 30 remaining patients at surgery was 23 months (range 11-119). At follow-up, 28 (94%) patients had retractile foreskins that had healed well. One patient (3%) had a foreskin fistula and the parents chose to proceed with circumcision rather than fistula closure. A second patient (3%) developed late phimosis secondary to balanitis xerotica obliterans and also underwent circumcision. Twelve follow-up questionnaires were returned. The median overall success rating of the operation was 4.7/5.0 (94%). All respondents reported that they would recommend the procedure to another parent whose child has a similar diagnosis.


Isolated preputial reconstruction improves the cosmetic appearances in distal hypospadias, has a low complication rate and offers high parental satisfaction.

Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.


Distal hypospadias; Foreskin; Prepuce; Reconstruction

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