Etiologic considerations in penoscrotal hypospadias repair

Superficial location of fivrous bands causing chordee in patients with penoscrotal hypospadias has been demonstrated by microscopic and gross photographs. Our technique to manage this problem is similar to that described by Allen and Spence and by King for distal hypospadias and has been used in 120 patients. The technique involves the repair of the embryologic penile defect by advancing the closure of the urethral groove and transposing the scrotum to its appropriate caudal position. The repair is applicable in patients with failure of fusion rather than failure of the development of the urethral groove as in perineal hypospadias.