Concepts in the surgical technique of one-stage hypospadias correction.

[OBJECTIVE] To report on a single-stage technique for hypospadias repair based on the combination of several features of established methods and to emphasize the importance of identifying and excising the chordee that is almost always present in the tissues proximal to the urethral opening to ensure the complete correction of this deformity.

[PATIENTS AND METHODS] Over a 3-year period, 84 boys (age range from 8 months to 14 years) underwent a single-stage repair of proximal hypospadias. Chordee was corrected by excising fibrotic tissue representing the atretic corpus spongiosum proximal to the urethral opening. The neourethra was constructed using the epithelium distal to the urethral opening and part of the dorsal prepuce.

[RESULTS] Satisfactory results were obtained in 79 patients with a single procedure. Only five patients had fistulae and of these, four were closed successfully during the same hospital stay.

[CONCLUSION] Proximal hypospadias can be corrected using the single-stage technique described, with satisfactory results in most cases. Fistulae are uncommon and can be closed by a primary procedure performed in the post-operative period.