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Pediatric Chordee Release and Glanular Hypospadias Repair

Domingo Alvear, MD1; Lissa Henson, MD2; Jaymie Ang Henry, MD, MPH3

1World Surgical Foundation
2Philippine Society of Pediatric Surgeons
3Florida Atlantic University, G4 Alliance

Abstract

Hypospadias is a congenital malformation that affects the urethra and foreskin of the penis. The urethral opening is ectopically located on the underside of the penis in any place from the glans penis to the scrotum, and the penis is more likely to have associated ventral shortening and curvature called chordee. Hypospadias is common, occurring in 1 out of every 250 to 300 newborn males and has been related to certain factors in the mother such as obesity, age over 35 years, use of fertility and hormonal treatment, and smoking. Hypospadias is characterized as glanular, distal, midshaft, penoscrotal, or proximal, with glanular being the most common. Diagnosis is usually made during physical examination after birth. Hypospadias can be repaired with surgery and is done at 6 to 24 months old when penile growth is minimal. If it is not treated, hypospadias can lead to problems such as having to sit down to urinate or difficulties with sexual intercourse and fertility. The goals of the surgery are to correct the curvature of the penis and to relocate the urethral meatus to its correct position. Here, we present the case of a 13-year-old male with glanular hypospadias and chordee. Release of the chordee was performed to straighten the penis, and repair of the glanular hypospadias was performed using the meatal-advancement technique.

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