The foreskin is trimmed and evened out. How the new urethra is made varies on the surgeon's preference, and I usually tubularize the urethral plate to finish off the job that mother nature started. Sometimes a dressing is used, and a catheter to let the new urethra heal as well. In severe cases 2 or more procedures may be required to achieve all 3 goals. Complications of treatment are best avoided by performing a meticulous operation using the principles of plastic surgery.
Prognosis is excellent.
The dartos flap as an adjunct in preventing urethrocutaneous fistulae in redo hypospadias surgery.