Surgical Techniques For Hypospadias: Which Technique?

Original article


Abdulsalam Tabib (Supervised by Mustafa Zaidi)

Burns & Plastic Surgery Hospital, Tripoli, Libya

JMJ Vol. 1, No. 1 (June 2001): 24-26


Hypospadias is a relatively common birth defect that occurs in approximately one out of every 350 male births. It is the commonest congenital anomaly of the urethra and is defined as an ectopic opening on the under surface of penis or perineum.
The type of hypospadias depends on the site of the abnormal opening of meatus on the under surface of penis.
Chordee (area downward curve of penis) may be associated with hypospadias. Boys with chordee often must sit down to void urine. The deformity is usually mild but a sever curvature from chordee can make sexual intercourse impossible.
The aetiology of hypospadias is not known, but the condition results from abnormal development of the urethra in the embryo and not from any thing the parents didn’t do during pregnancy.
Hypospadias will occasionally occur in more than one male in a family. The condition is corrected surgically. Depending on the severity, the correction can be completed in a single stage with different types of techniques. The best age for surgery depends on the size of the penis and degree of defect. Repair is usually advised at an early age. Correction surgery should result in a penis that looks normal and functions normally.
It used to be common to repair the anomaly with procedures requiring several surgical stages before the child started school. We now believe that repair of hypospadias should be accomplished in one procedure (surgical single stage technique). This involves:

1. Break down of chordee and straightening of the penis
2. Constructing a new urethra at the tip of the glans
There are more than 200 types of procedures, but only certain types have been commonly used.

Keywords: Hypospadias, Flip flap urethroplasty, Urethral advancement, Modified flip flap, Mathieu technique