Management of severe hypospadias with a 2-stage repair

A. B. Retik, S. B. Bauer, J. Mandell, Craig A Peters, A. Colodny, A. Atala

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88 Scopus citations


From 1986 to 1993 we treated 1,437 children with hypospadias of whom 58 had scrotal or perineal hypospadias with severe chordee and a small phallus. These patients underwent a 2-stage surgical repair. The first stage of the procedure included correction of the chordee and advancement of preputial flaps ventrally and distally to the superior aspect of the glans. After 6 to 12 months the second stage of the procedure was performed using the previously transferred preputial skin to reconstruct the glans and urethra. A second layer of subcutaneous tissue or tunica vaginalis was used in several instances. A penile nerve block and a transparent biomembrane dressing (Tegaderm) allowed for early postoperative mobilization. Excellent functional and cosmetic results were achieved. There is a subset of patients with severe proximal hypospadias, chordee and a small phallus who may benefit best from a 2-stage procedure. In these children a 2-stage repair allows for a better cosmetic appearance and a lower complication rate than a 1-stage repair with a free or vascularized graft.

Original languageEnglish (US)
Pages (from-to)749-751
Number of pages3
JournalJournal of Urology
Issue number2 II
StatePublished - 1994


  • graft survival
  • hypospadias
  • penis
  • urethra

ASJC Scopus subject areas

  • Urology


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