Urethral advancement for distal hypospadias repair in circumcised patients.

A new hypospadias repair technique is presented for distal cases. It is a modified form of the old Beck-Hacker technique and applicable only for distal hypospadias patients with minimal or no chordee. It consists of bringing the abnormally localized meatus to the tip of the glans penis by freeing and advancing the distal urethra. Thirty cases were operated on with this technique in the past 2 1/2 years with better results. The advantages of this simple technique can be summarized as follows: (1) it is easy to apply; (2) it can be applied to circumcised patients; (3) it can be done under local anesthesia even in the office; (4) the total length of the urethra is normal in its mucous membrane; (5) stricture formation is minimized by this solo glandular triangular flap; (6) ther is no need for a catheter; and (7) patients urinate freely during the healing process.