Introduction:

Hypospadias is a birth defect of the urethra in the male where the urinary opening is not at the usual location on the tip of the penis. In proximal hypospadias the meatus and specially the division of corpus spongiosum is near or within the scrotum or perineal. Repair of proximal hypospadias is a major challenge to the Pediatric surgeons

Methods:

We performed a retrospective study about 60 patients with a proximal hypospadias between Junary 2009 and june 2019.

Results:

Only six patients were diagnosed at birth in delivery room, and 12 were circumcised at diagnosis. Meatus was scrotal or penoscrotal in 50 patients, and chordee was sever and varied between 40 and 60. The scrotum bifidity or scrotal transposition in 18 cases. Eighteen cases of micropenis were identified and needed hormonal stimulation with good results in 12 cases. 47 patients were treated in one stage using more often modified Koyanagui procedure or double face transverse island flap. 13 cases had graft mucosa using buccal mucosa in 12 cases and preputial graft in 1 case. Tunica vaginalis flap was the most used intermediate layer in 28 cases. Urethral catheter was used for a mean period of 10 days. Fistula (11 cases) and meatus stenosis (4 cases), and glans disruption were the most common complications in our series.

Conclusion:

The management of proximal hypospadias is challenging. Different techniques must be kept in mind because there is no miraculous technique for all kind of proximal hypospadias.