Ventral penile lengthening using tunica vaginalis flap for correction of curvature in proximal hypospadias repair: Technical aspects

Abstract

The correction of ventral curvature in proximal hypospadias is an important principle, and typically the first step in proximal hypospadias repair. There is no consensus as to the best technique for correction for curvature. Dorsal plication, corporeal rotation, urethral plate mobilization, deep transverse incisions of the tunica albuginea, and ventral penile lengthening are all currently practiced. For ventral curvature over 45 degrees, the authors’ preference is to perform a corporoplasty to achieve ventral penile lengthening, using a tunica vaginalis flap (TVF), if available. Significant advantages of the TVF as compared to other techniques is an attached axial blood supply, without reliance on recipient bed for tissue vascularity. There is also minimal donor site morbidity as compared to dermal grafts. In this video, we aim to demonstrate this technique for ventral penile lengthening.

Keywords

• Hypospadias
• Island flaps
• Pedicled flaps
• Penis