Penoscrotal Transposition with Hypospadias: HAMBARDE's Technique of O-T-O PLASTY

Dr.Sandeep R.Hambarde; Dr.Ashwini S.Hambarde; Dr.Thavendra Dihare

Volume : VIII, Issue : IX, September - 2019

Penoscrotal Transposition with Hypospadias: HAMBARDE's Technique of O-T-O PLASTY

Dr. Sandeep R. Hambarde, Dr. Ashwini S. Hambarde, Dr. Thavendra Dihare

Abstract :

Background/ Purpose: Penoscrotal transposition , partial or complete is result of positional exchanges between the penis and the scrotum. Earlier correction of penoscrotal transposition was done transposing the penis to a neo hole created in the skin of mons pubis or creating scrotal rotational flaps and inging them caudal to penis. Modified Glenn Anderson�s method is commonly used. This method is known to cause major penile lymphoedema following surgery due to circular incision around the root of the penis that delay correction of the frequently associated hypospadias and increase the incidence of complications. We used novel method to correct 22 cases of penoscrotal transposition i.e.HAMBARDE`s Technique of O-T-O PLASTY. This method has given excellent cosmetic and functional outcome,allowed early surgical correction of hypospadias after 6 months with almost nil complications. Material and methods We retrospectively reviewed 22 patients ,age ranging from 2 to 23 years that underwent two-stage repair for penoscrotal transposition with hypospadias. The operative principle was based on achieving a normal anatomical position of the penis and scrotum using a novel method i.e. HAMBARDE`s technique of O-T-O PLASTY. All cases were associated with midpenile or penoscrotal hypospadias. Hypospadias correction was performed after a period of 6 months with Onlay tube urethroplasty. 7 patients were having unilateral undescended testis and 1 patient was having unilateral inguinal hernia. Results Cosmetic and functional results of HAMBARDE`s Technique of O-T-O PLASTY were excellent. No major complications were observed. Of 22 patients, only 2[9%] had fistula after hypospadias repair. Conclusion HAMBARDE`s Technique of O-T-O PLASTY for reconstruction of penoscrotal transposition is a simple technique, free of major complications. The purpose of this innovative method is to improve functional outcome and cosmetic appearance of the penis. A minimum period of 6 months between consecutive urethroplasties is important. Preserving the prepuce and making its use for subsequent urethroplasty after 6 months gives excellent short term and long term outcome.