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 aps and bringing them
caudal to penis.
Modied 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 stula 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.


Keywords


Penoscrotal transposition,hypospadias,HAMBARDE`s Technique , O-T-O PLASTY

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References


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