Perineal Hypospadias: The Bilateral-Based (BILAB) Skin Flap Technique

Abstract

The principle of the BILAB technique is to incise the short urethral plate, excise the hypoplastic corpus spongiosum, split the glans, and reconstruct a new healthy urethral plate from the lateral penile skin and foreskin from both sides to the tip of the glans. This lateral skin is fixed to the tunica albuginea in the midline to provide stability and blood supply. The new urethra is reconstructed from the new urethral plate to the tip of the glans as a one-or two-stage procedure. When performed as a two-stage procedure, the severe chordee is corrected, and a new healthy urethral plate from the foreskin is reconstructed (called STAC or straighten and close by some authors), and the urethra is reconstructed 6 months later as a second stage.