[Correction of severe median hypospadias. Review of 77 cases treated by the onlay island flap technic].

Seventy-seven hypospadias, selected from a series of 504 treated in our institution, were operated using the pediculated transverse "onlay" preputial graft. We try to demonstrate that this technique produces excellent functional and cosmetic results. Chordee can be corrected using extensive dissection of the urethral plate with association, if necessary, of a Nesbit type of dorsal plication. Complications rate, in our hands, is lower in comparison to the technique described by John Duckett, where the urethral plate is divided and a complete urethral tube is performed. We report 4 fistulas, one distal end breakdown of the repair and one postoperative hematoma that had to be revised. Because of this low complication rate, in many cases, the "onlay" pediculated graft replaces advantageously the Duckett type of repair.