Chordee correction by corporal rotation: the split and roll technique

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Ventral chordee in severe hypospadias presents complex surgical challenges.
• Existing methods like dorsal plication can cause penile shortening, and grafts may necessitate staged procedures.

Purpose of the Study:

• To present an alternative surgical approach using corporal rotation to correct ventral chordee in severe hypospadias.
• To evaluate the efficacy of this technique in achieving phallic straightening and preserving penile length.

Main Methods:

• A ventral midline incision was used to split the septum between corpora cavernosa, facilitating corporal rotation.
• Neurovascular bundles were elevated and preserved by dissecting Buck's fascia dorsally.
• Nonabsorbable sutures were placed and tied to rotate corpora toward the dorsal midline, correcting curvature.

Main Results:

• The corporal rotation technique achieved excellent intraoperative phallic straightening in all six patients.
• No incisions into the corporal substance or use of grafts were required.

Conclusions:

• The split and roll technique offers a single-stage solution for severe hypospadias chordee.
• This method avoids phallic shortening and preserves neurovascular bundles, maximizing penile length.