Should We Routinely Test for Chordee in Patients with Distal Hypospadias?

 

 Buy Article Permissions and Reprints

Abstract

Objectives The aim of this study was to determine the incidence of chordee in distal hypospadias and compare our intraoperative findings with those reported by the families of patients and to determine if routine testing for chordee should be performed in patients with distal hypospadias.

Material and Methods Surgical reports and medical files of distal hypospadias patients operated from January 2008 to January 2013 were prospectively reviewed. The type of hypospadias, family's report of chordee, intraoperative finding of chordee and its degree were noted. All patients were tested for chordee intraoperatively after degloving.

Results A total of 156 patients of which 27 had glandular, 61 coronal, and 68 subcoronal hypospadias were included in the study. Chordee was found in 52 patients (33.3%) intraoperatively, whereas only 15 families (9.6%) reported chordee preoperatively.

Conclusion There is risk of chordee in patients with distal hypospadias that needs to be accurately identified and corrected. Families are not always aware of the presence of chordee.

• References

• 1 Stojanovic B, Bizic M, Majstorovic M, Kojovic V, Djordjevic M. Penile curvature incidence in hypospadias: can it be determined?. Adv Urol 2011; 2011: 813205
  PubMedGoogle Scholar
• 2 Castagnetti M, El-Ghoneimi A. The influence of perioperative factors on primary severe hypospadias repair. Nat Rev Urol 2011; 8 (4) 198-206
  CrossrefPubMedGoogle Scholar
• 3 Paulozzi LJ, Erickson JD, Jackson RJ. Hypospadias trends in two US surveillance systems. Pediatrics 1997; 100 (5) 831-834
  CrossrefPubMedGoogle Scholar
• 4 Leung AKC, Robson WLM. Hypospadias: an update. Asian J Androl 2007; 9 (1) 16-22
  CrossrefPubMedGoogle Scholar
• 5 Perovic SV, Djordjevic ML, Djakovic NG. A new approach to the treatment of penile curvature. J Urol 1998; 160 (3 Pt 2): 1123-1127
  CrossrefPubMedGoogle Scholar
• 6 Tal R, Nabulsi O, Nelson CJ, Mulhall JP. The psychosocial impact of penile reconstructive surgery for congenital penile deviation. J Sex Med 2010; 7 (1 Pt 1): 121-128
  CrossrefPubMedGoogle Scholar
• 7 Gittes RF, McLaughlin III AP. Injection technique to induce penile erection. Urology 1974; 4 (4) 473-474
  CrossrefPubMedGoogle Scholar
• 8 Paulozzi LJ. International trends in rates of hypospadias and cryptorchidism. Environ Health Perspect 1999; 107 (4) 297-302
  CrossrefPubMedGoogle Scholar
• 9 Bracka A. Sexuality after hypospadias repair. BJU Int 1999; 83 (Suppl. 03) 29-33
  PubMedGoogle Scholar
• 10 Rey RA, Codner E, Iñíguez G , et al. Low risk of impaired testicular Sertoli and Leydig cell functions in boys with isolated hypospadias. J Clin Endocrinol Metab 2005; 90 (11) 6035-6040
  CrossrefPubMedGoogle Scholar
• 11 Kenneth CH, Leung AK. Hypospadias: a review. J Singapore Paediatr Soc 1987; 29 (1) 54-56
  PubMedGoogle Scholar
• 12 Aho MO, Tammela OK, Somppi EM, Tammela TL. Sexual and social life of men operated in childhood for hypospadias and phimosis. A comparative study. Eur Urol 2000; 37 (1) 95-100 , discussion 101
  CrossrefPubMedGoogle Scholar
• 13 Chen Y-M, Zou D-W. [A new procedure for repairing coronal or subcoronal hypospadias with severe chordee]. Zhonghua Zheng Xing Wai Ke Za Zhi 2005; 21 (2) 109-111
  PubMedGoogle Scholar
• 14 Soygur T, Filiz E, Zumrutbas AE, Arikan N. Results of dorsal midline plication in children with penile curvature and hypospadias. Urology 2004; 64 (4) 795-798 , discussion 798
  CrossrefPubMedGoogle Scholar
• 15 Bar Yosef Y, Binyamini J, Matzkin H, Ben-Chaim J. Midline dorsal plication technique for penile curvature repair. J Urol 2004; 172 (4 Pt 1): 1368-1369
  CrossrefPubMedGoogle Scholar
• 16 Chertin B, Koulikov D, Fridmans A, Farkas A. Dorsal tunica albuginea plication to correct congenital and acquired penile curvature: a long-term follow-up. BJU Int 2004; 93 (3) 379-381
  CrossrefPubMedGoogle Scholar
• 17 Hayashi Y, Kojima Y, Mizuno K, Tozawa K, Sasaki S, Kohri K. Modified technique of dorsal plication for penile curvature with or without hypospadias. Urology 2002; 59 (4) 584-586 , discussion 586–587
  CrossrefPubMedGoogle Scholar
• 18 Snodgrass W, Prieto J. Straightening ventral curvature while preserving the urethral plate in proximal hypospadias repair. J Urol 2009; 182 (4, Suppl): 1720-1725
  CrossrefPubMedGoogle Scholar
• 19 Braga LHP, Lorenzo AJ, Bägli DJ , et al. Ventral penile lengthening versus dorsal plication for severe ventral curvature in children with proximal hypospadias. J Urol 2008; 180 (4, Suppl): 1743-1747 , discussion 1747–1748
  CrossrefPubMedGoogle Scholar
• 20 Baskin LS, Duckett JW, Lue TF. Penile curvature. Urology 1996; 48 (3) 347-356
  CrossrefPubMedGoogle Scholar
• 21 Baskin LS, Duckett JW, Ueoka K, Seibold J, Snyder III HM. Changing concepts of hypospadias curvature lead to more onlay island flap procedures. J Urol 1994; 151 (1) 191-196
  CrossrefPubMedGoogle Scholar
• 22 Samuel M, Capps S, Worthy A. Distal hypospadias: which repair?. BJU Int 2002; 90 (1) 88-91
  PubMedGoogle Scholar
• 23 Snodgrass W, Macedo A, Hoebeke P, Mouriquand PDE. Hypospadias dilemmas: a round table. J Pediatr Urol 2011; 7 (2) 145-157
  CrossrefPubMedGoogle Scholar
• 24 Djordjević M, Stojanković B, Stojsavljević M, Ducić S, Bizić M, Majstorović M. Incidence of penile curvature in various forms of hypospadias [article in Serbian]. Srp Arh Celok Lek 2009; 137 (7-8) 391-395
  CrossrefPubMedGoogle Scholar
• 25 Ekmark AN, Svensson H, Arnbjörnsson E, Hansson E. Postpubertal examination after hypospadias repair is necessary to evaluate the success of the primary reconstruction. Eur J Pediatr Surg 2013; 23 (4) 304-311
  Article in Thieme ConnectPubMedGoogle Scholar