Introduction:

Fistula and glans dehiscence still the most frequent complications of the hypospadias surgery. Different intermediate layers have been reported to reduce the rate of complications. Our aim is to report a modified glans dissection respecting the continuity between glans and corpus spongiosum and facilitating a multilayer coverage.

Patients and methods:

A retrospective study between 2013 and 2015 of 88 patients operated on using the modified technique. Follow-up based on local examination and visual assessment of urine stream and parent satisfaction was recorded at 1 month,3 months, 6 months, 1 year and then yearly.

Results:

Fifty two patients had a double intermediate layer and thirty six had a triple intermediate layer. Eighty six patients had satisfactory results but one patient had a fistula that healed spontaneously and one patient presented with a glans disruption.

Discussion:

Double dartos flap is more effective to prevent fistula than a single flap. Extended wing glans dissection respecting the continuity between glans and corpus spongiosum may result in a well vascularized glans that could prevent glans dehiscence.

Conclusion:

The modified multilayer coverage associated with the respect of the continuity of the glans and corpus spongiosum could improve the outcome of the distal hypospadias surgery.