Chordee without hypospadias in children

Area of Science:

• Pediatric Urology
• Surgical Reconstruction
• Genitourinary Surgery

Background:

• Chordee without hypospadias presents a surgical challenge in pediatric patients.
• Understanding the underlying tissue anomalies is crucial for effective correction.
• Previous surgical techniques have varied in addressing penile curvature.

Purpose of the Study:

• To evaluate surgical outcomes for chordee without hypospadias in children.
• To identify the primary causes of ventral penile curvature in this cohort.
• To assess the efficacy of different surgical techniques in achieving functional and cosmetic results.

Main Methods:

• Retrospective review of 20 pediatric patients undergoing chordee correction.
• Classification of chordee based on etiology: corporeal disproportion, dartos fascia deficiency (skin chordee), or combined fascial deficiency.
• Surgical interventions included Nesbit principle (dorsal ellipses excision), Allen-Spence technique (dartos lysis), urethral mobilization with fibrous tissue excision, and staged urethroplasty.

Main Results:

• Ventral curvature was attributed to corporeal disproportion (9 patients), dartos fascia deficiency (8 patients), and combined fascial deficiency (3 patients).
• Surgical techniques yielded satisfactory cosmetic and functional results in all 20 patients.
• Achieved outcomes included penile straightening and a distally located urethral meatus at the glans tip.

Conclusions:

• Penile chordee without hypospadias in children often stems from anomalies in the penis's fascial layers.
• Excision of abnormal fascial tissue is an effective method for penile straightening.
• Surgical correction provides excellent cosmetic and functional results, improving quality of life.