Pediatric surgery Hypospadias 1 cordee correction

Hypospadias

Definition

In cases of developmental defect of urethra, leading to position­ing of the urinary meatus proximally on the ventral surface of penis and also resulting in:

•   Distortion of the penis (chordee) 

•   Misdirected urinary stream 

•   Possible difficulty in reproductive functions later.

Objectives

•   To correct chordee if present 

•   Reconstruction of urethra from opening to tip.

Position

Supine.

Anesthesia

General with endotracheal intubation.

Chordee Correction

Procedure

1.  Hold the glans with stay sutures.

2.  Inject normal saline in glans to check chordee.

3.  Excise the fibrous cord, if any.

4.  Readjust the prepuce on the ventral surface.

5.  Advance the prepucial skin to the edges of the navicular fossa.

6.  Close the wound in 2 layers.

7.  Drain the bladder with a urethral catheter

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