This protocol targets a particularly challenging presentation: patients who have undergone multiple prior hypospadias procedures that failed, leaving behind scarred penile tissues, an inadequate urethra, and an abnormal urethral meatus.
Patients who underwent several previous failed surgical procedures — sometimes referred to as the hypospadias cripple — present with scarred tissues, inadequate urethra, abnormal meatus, and complications such as fistula and dehiscence of varying severity. The degree of residual scarring and tissue quality are central to determining how to proceed.
Management in this setting typically begins with preoperative preparation aimed at optimising tissue conditions before surgery — after which the choice of reconstructive technique depends on the state of the urethral plate and the extent of scarring present.
DOI: 10.4103/0970-1591.40621