Comparison of the Outcomes of Preputial Buttonhole Flap Versus Byars Flap Techniques in Hypospadias Treatment

Background: Hypospadias, a prevalent congenital anomaly, is characterized by the incomplete development of the urethral spongiosum and the ventral prepuce. The current standard of care for hypospadias not only targets the attainment of a functional penis, facilitating sexual intercourse and upright urination, but also emphasizes an aesthetically pleasing outcome. The surgical techniques for treating hypospadias are continually advancing. Methods: In this study, two distinct skin coverage techniques used in hypospadias repair were compared. The Snodgrass technique was used to repair all 40 cases included in our study. In half of the cases (n = 20), an inner preputial buttonhole flap was used for skin coverage. For the remaining cases, a Byars flap was employed as a waterproof layer. The minimum period of follow-up was six months. Finally, data related to the surgical outcomes and the patients’ demographic characteristics were collected and analyzed using SPSS software. Results: The average age of the patients in this study was 26.1 months (SD, 8.5). The results indicated that there was no significant difference between the preputial buttonhole flap and Byars flap techniques in the treatment of hypospadias, considering factors, such as urethral fistula, meatal stenosis, and the need for a repeat surgery postoperatively (P > 0.05). Conclusions: Our findings suggest that the preputial buttonhole flap technique may be more effective than the Byars flap surgery in neourethra coverage for preventing fistulas in distal hypospadias. However, to substantiate these findings, further studies with larger sample sizes are required.