Extending the Graft Harvesting Area in Severe Penoscrotal Hypospadias: The Rainbow Technique.
Ziyad Alzahrani, Geemitha Ratnayake, Yaqoub Jafar et al.
✦ AI-curated · Sources linked
Case in brief
A 2-year-old with severe penoscrotal hypospadias, a scrotal meatus, bifid scrotum, and chordee exceeding 90° underwent first-stage reconstruction. After chordee correction, the ventral penile defect measured 6 cm, while the inner preputial diameter was 4 cm—too short for a conventional rectangular graft. A semicircular dorsal preputial incision yielded a 7 cm graft, which was used for staged tubularized autograft repair. At six months, the graft was well integrated without contraction; the child was awaiting the second-stage repair.
What made this case unusual
The rainbow-shaped harvest extended preputial graft length beyond what the conventional rectangular harvest could provide, allowing coverage of the long ventral defect without buccal mucosa.
Diagnostic / clinical pearl
When a conventional preputial graft is too short for a proximal hypospadias defect, a semicircular dorsal harvest may provide additional length for first-stage coverage.