Hydrodissection technique to preserve the thin distal urethra when correcting chordee without hypospadias.

Abstract

We introduce a hydrodissection technique to preserve the thin distal urethra when treating chordee without hypospadias. A total of 18 patients with chordee but without hypospadias were surgically treated in 3 years, including 7 (38.9%) with a segment of thin distal urethra. A hydrodissection technique was used to preserve the thin distal urethra in 6 patients with a mean age plus or minus SD of 9.0 +/- 3.6 years. Artificial erection was induced after circumcision and penile skin degloving. Tunica albuginea plication to correct residual chordee was needed in only 1 patient. The thin distal urethra was covered by preputial subcutaneous tissue in 3 cases and by Y to I spongioplasty in 3. All 6 thin distal urethras were preserved. The thin distal urethra was a mean of 23.3 +/- 3.9 mm. long and mean followup was 17.8 months. Postoperatively penile cosmesis was excellent in all patients and urinary flow was normal. Using the hydrodissection technique to preserve the thin distal urethra simplifies the operation of correcting chordee without hypospadias by avoiding additional urethroplasty and tunica albuginea plication for residual chordee.