Urethral Mobilization Procedure

Urethral mobilization has been reported previously in the literature, however the modifications suggested by McKenna are distinct. This technique removes the risk of common postoperative complications such as urethral fistula since there is no suture line. The development of wide glanular flaps with a flair provides an excellent meatal cosmetic result while decreasing the risk of meatal stenosis. During the procedure the urethra is mobilized from the bottom up rather than the top down. This preserves the blood supply by leaving the spongiosal tissue intact. This procedure, although technically more difficult than a standard hypospadias repair, provides an option for repair of distal hypospadias, redo hypospadias, and can be utilized in all cases including proximal hypospadias to decrease the length of vascularized flaps. This procedure is particularly helpful in patients with stenotic TIP procedures who lack excess preputial skin. In redo procedures it usually results in only one operation as opposed to multiple.