Abstract：
OBJECTIVE:To accurately measure the correction obtained by the release of the skin and dartos fascia and that obtained by mobilization of the urethral plate and resection of the underlying fibrous tissue (according to Koyanagi and Mollard), in the release of chordee. METHODS:From February 1996 to February 2011, 234 patients underwent surgery for proximal hypospadias by 1 surgeon. Lateral photographs were taken during successive saline erection tests for 205 patients. The first test was performed at the beginning of the operation, the second test after the release of the skin and dartos fascia, the third test after possible mobilization of the urethral plate and resection of the underlying fibrous tissue, and the last test at the end of surgery. RESULTS:Preservation of the urethral plate was possible in 191 patients (93%). Analysis of the lateral photographs showed that stripping of the penis resulted in complete correction of all chordee <45°. For curvature >90°, stripping of the penis was insufficient in 88% of the cases. However, mobilization of the urethral plate with resection of the underlying fibrous tissue resulted in very low correction (10°-20°), although the blood supply to this plate was preserved. CONCLUSION:The results of the present study have shown that correction of the curvature that accompanies proximal hypospadias is obtained mainly by release of the skin and dartos fascia.
journal_name
Urologyjournal_title
Urologyauthors
Acimi Sdoi
10.1016/j.urology.2012.06.050subject
Has Abstractpub_date
2012-10-01 00:00:00pages
894-8issue
4eissn
0090-4295issn
1527-9995pii
S0090-4295(12)00761-3journal_volume
80pub_type
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