Chordee Correction During Hypospadias Repair

Penile chordee is one of the main attributes of hypospadias, especially in proximal forms. Appropriate diagnosis is confirmed either by artificial or pharmacological erection—induced by prostaglandin E1 (PGE1)—during hypospadias repair. In children, preoperative photographs of the erect penis are helpful in preparation of repair. Surgical correction of chordee is necessary for a functionally and cosmetically normal penis. In children, straightening of the penis is usually achieved by simple plication of the tunica albuginea on the convex (longer) side. In adolescents and adults, correction of the chordee can be done either by plication of the incised tunica albuginea or by grafting the concave (shorter) side of the corpora cavernosa. Grafting of the corpora is the method of choice if preserving penile length is important. Special care should be taken in redo cases due to the potential paucity of healthy local tissue, additional deformities, and potential need for repeat urethroplasty [1, 2].