Congenital urethral fistula with chordee.

The tenth reported case of congenital urethral fistula with chordee was repaired by a 1-stage procedure. The ventral intact prepuce was used to form a tubular pedicle flap from which the distal portion of the new urethra was constructed. The proximal neourethra was fashioned from a tubular pedicle flap based at the proximal fistulous orifice. The prevailing hypothesis advanced for the etiology of hypospadias postulates a deficiency of testicular evocator substance prior to complete formation of the urethra. This theory inadequately explains the genesis of congenital urethral fistula as well as chordee without hypospadias. Congenital urethral fistula and congenital chordee without hypospadias are best explained by the theory of deficient urethral plate.