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Hydrodissection technique to preserve the thin distal urethra when correcting chordee without hypospadias
Stephen Shei Dei Yang1, Shyh Chyan Chen, Shih-Ping Liu
1Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
Purpose:
We introduce a hydrodissection technique to preserve the thin distal urethra when treating chordee without hypospadias.
Materials And Methods:
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.
Results:
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.
Conclusions:
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.