Preservation of urethra devoid of corpus spongiosum in patients undergoing urethroplasty

Abstract

Introduction: Hypospadias repair is done in many centers using tubularized incised plate urethroplasty technique. A varying length of distal urethra in almost one-fourth of patients is devoid of corpus spongiosum. Traditionally, this segment is incised proximally till ′healthy′ urethra is reached. It makes hypospadias more proximal and thus increases chances of failure. Materials and Methods: We tried to preserve this thin so-called "hypoplastic" urethra in nine patients. The meatus was distal penile in four, mid-penile in four and proximal penile in one patient. Another patient with chordee without hypospadias with hypoplastic urethra underwent chordee correction without sacrificing any length of urethra. Results: No residual chordee was seen in any of the patients. Only two patients (22%) developed subcoronal fistulas needing secondary repair. No patient had urethral diverticulum or stricture. Conclusions: We thus recommend preservation of hypoplastic urethra whenever possible.

Keywords

• Chordee
• corpus spongiosum
• hypoplastic urethra
• hypospadias
• tubularized incised plate urethroplasty