OUTCOMES OF SINGLE-STAGE THIERSCH-DUPLAY TECHNIQUE WITH DARTOS FLAP REPAIR FOR MID AND DISTAL HYPOSPADIAS: A SEVEN-YEAR EXPERIENCE IN HOSPITAL PAKAR UNIVERSITI SAINS MALAYSIA (HPUSM)
Keywords:
Hypospadias; Thiersch–Duplay; dartos flap; HOSE score; Malaysia.Abstract
Background: Outcome data on single-stage Thiersch–Duplay hypospadias repair with dartos flap reinforcement from Malaysian centres are limited. Objective: To evaluate surgical, functional, and cosmetic outcomes of single-stage Thiersch–Duplay repair for mid and distal hypospadias at Hospital Pakar Universiti Sains Malaysia (HPUSM). Methods: This retrospective observational study reviewed hypospadias surgeries performed from January 2019 to December 2025. Among 65 cases, 21 underwent Thiersch–Duplay repair; 2 were excluded due to incomplete data, leaving 19 for analysis. Demographics, operative details, complications, and HOSE outcomes (parental telephone interview) were evaluated. Results: Mean age at surgery was 6.74 ± 4.90 years. Distal hypospadias comprised 13 (68.4%) and midshaft 6 (31.6%); chordee was present in 10 (52.6%). Complications occurred in 5 (26.3%) patients: fistula 2 (10.5%), wound dehiscence 2 (10.5%), and hematoma 1 (5.3%). Revision surgery was required in 3 (15.8%). Mean HOSE score was 14.58 ± 1.50, with 15 (78.9%) achieving HOSE ≥14. Conclusion: Single-stage Thiersch–Duplay repair with dartos flap reinforcement achieved favourable HOSE outcomes with acceptable complication rates at HPUSM.
Key words: Hypospadias; Thiersch–Duplay; dartos flap; HOSE score; Malaysia.
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