[Modification of one-stage urethral plastic surgery by Hodgson III in proximal hypospadia in boys].

From 1996 to 1999 45 boys with proximal hypospadia (PH) aged 8 months to 15 years were operated according to modified one-stage urethral plastic operation according to Hodgson III for correction of complicated PH. 23 of them were untreated and 22 were surgically treated with unsatisfactory results. Corpus hypospadia with gross deformity of the cavernous bodies was observed in 15 patients. 12 and 18 boys had corpus-scrotal and scrotal hypospadia, respectively. Urethral plasty was carried out by Duckett (n = 5), Hodgson I (n = 4), Hodgson III (n = 13), Hodgson III modification (n = 23). The modification consists in additional dissection of a wide scrotal graft which is sutured in a tube prolonging urethra and widening anastomosis with the graft. The external urethral orifice is created on the top of the glans penis by mobilization of the wings of the glans penis with consecutive longitudinal cuts. Longitudinal surface relaxing cuts in chess order are made on the flap skin covering corpus penis to diminish tissue tension. 6-month to 3.5-year follow-up results are available. Complications (stenosis of the urethral external orifice, urethral fistulas and stenosis of anastomotic zone) were observed in 10 patients. Thus, the modification reduced the number of complications, improved functional and cosmetic results. The paper also contains a draft hypospadia classification, techniques of changing cavernous bodies' deformity angle, methods of artificial erection.