الفهرس 
Introduction and Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Hypospadias is a common congenital defect thought to be caused by incomplete fusion of the urethral folds, resulting in a proximally located urethral meatus anywhere from the glans to the perineum.
Hypospadias is an extremely common congenital anomaly with an incidence of about one per 125 to one per 300 live male births.
Three main features characterize hypospadias, a ventral position of the meatus, a dorsal hooded foreskin and a ventral curvature on erection. The reason for correcting this deformity is to allow micturition whilst standing, to achieve a natural appearance and to allow normal sexual function.
Many classifications for hypospadias were made in a trial to select the best operation for each type, all of them depend on the site of the meatus especially after correction of the chordee.
Surgery to repair hypospadias has a history of more than 150 years. To date more than 300 surgical procedures with accompanying variation have been proposed for the repair of hypospadias. Such repair should be simple, easily learned, applicable to the majority of cases, completed in a single stage and resulting in pleasing cosmetic result with a low complication rate.
Hypospadias repair is either primary that had no previous operations, or secondary ”hypospadias cripple” who had been previously operated upon several times.
Hypospadias cripple can be also defined as patients with remaining functional complications after hypospadias repair. The term hypospadias cripple is admittedly pejorative yet it aptly describes these unfortunate patients.
Repeat hypospadias repair continues to be a challenging operative experience. Fortunately, in the recent past, improved operative techniques, advances in surgical instrumentations, magnifications and suture material have decreased the number of patients with repeated complications. However, there remains a small group of children who require repeated operative repair of the urethra and who lack non hair bearing genital tissue. These complications are unfortunate consequence of hypospadias repair, ranging from a small fistula that requires only simple closure to complete loss of the neourethra, requiring total reconstruction.
Surgical therapy of these complications can be challenging, especially for the patients who have no sufficient penile and preputial skin to be used for a neourthera. Many procedures with many different urethral substitutions have been described for the repair of complications.