Meatal and corpus spongiosum advancement: a better technique for distal hypospadias repair.

OBJECTIVE: Several procedures have been described for repair of distal hypospadias. However, these are not without any complications. Corpus spongiosum advancement is a new technique employed in our patients for distal hypospadias repair with excellent clinical outcome and no post-operative complications. PATIENTS AND METHODS: A total of 56 patients aged from 24 to 126 months were operated between January 2009 and August 2011. 32 patients had coronal, 9 had glanular and 15 had distal penile hypospadias. The meatus was located within 1 cm of the corona in all the patients. There was minimal or no chordae. All the patients underwent advancement of corpus spongiosum. RESULT: The mean operating time was 36 min and mean operating blood loss was 15 ml. In three patients, the corpus spongiosum was opened inadvertently during dissection. It was repaired with 5-0 vicryl and stitched to the cavernosal bed. An indwelling catheter was kept for 5 days. None of these three patients had any problem after removal of the catheter. Mean hospital stay was 0.5 days (0-6 days). 42 patients were discharged from the hospital on the day of surgery. Eight patients complained of dysuria on the first day. There were no other complications. The functional and cosmetic results have been excellent. The mean follow-up period was 16 months (8-38 months).
CONCLUSION: Corpus spongiosum advancement is an easy technique, consumes less time and has excellent cosmetic and functional outcome. The procedure is most suitable for children with distal hypospadias without chordae.