Outcomes of Onlay Island Flap (OIF) Versus Dorsal Inlay Graft (DIG) for Repair of Anterior and Middle Hypospadias with Narrow Urethral Plate: A Comparative Study

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Background:Hypospadias is a common congenital anomaly of the male urethra that often necessitates surgical repair, particularly when a narrow urethral plate is present. Various techniques, including the Dorsal Inlay Graft (DIG) and Onlay Island Flap (OIF), have been developed to optimize outcomes. This study compares the efficacy and outcomes of the DIG and OIF techniques in repairing anterior and middle hypospadias with narrow urethral plates.Methods:A retrospective review was conducted on 48 male patients with anterior and middle hypospadias and narrow urethral plates who underwent surgery between 2018 and 2022. Patients were divided into two groups: 22 underwent the OIF technique and 26 underwent the DIG technique. Clinical characteristics, surgical details, and postoperative complications were collected from medical records. Outcomes were assessed using the Hypospadias Objective Scoring Evaluation (HOSE) score after at least six months of follow-up. Parental satisfaction was evaluated using the Pediatric Penile Perception Score (PPPS).Results:No significant differences were found between the two groups regarding age, hypospadias type, or degree of chordee. Postoperative complications occurred in 13.5% of the OIF group and 15% of the DIG group, with no statistically significant difference. Functional and cosmetic outcomes, based on HOSE scores and parental satisfaction, were comparable between groups.Conclusion:Both the Dorsal Inlay Graft and Onlay Island Flap techniques are safe and effective for repairing anterior and middle hypospadias with narrow urethral plates, offering favorable outcomes with low complication rates.Keywords: Hypospadias, Urethral Plate, Onlay Island Flap, Dorsal Inlay Graft, Pediatric Urology.

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