Cecil Culp Procedure

Every hypospadias surgery presents unique challenges to surgeons striving for a successful repair. As no two surgeries are completely alike there are numerous technical variations surgeons utilize to optimize outcomes. Paucity of skin and lack of vascularized tissue can be significant barriers for healing in re-operative but also primary hypospadias repairs. Wounds closed under tension can lead to poor capillary vascular flow resulting in skin breakdown and potentially breakdown of the entire repair. In this chapter, we discuss the Cecil Culp technique first described in the 1950s for proximal hypospadias cases (Cecil, J Urol 56(2):237–242, 1946). As with most procedures, the technique has evolved over time but remains a fairly simple solution for complex reconstruction in patients with a lack of ventral skin during closure. With time, indications for this technique have expanded beyond hypospadias surgery, within our institution we utilize it in select cases of chordee correction, circumcision injuries as well as degloving genital trauma cases (Weiss et al., Urology 106:196–199, 2017). The Cecil Culp technique is an excellent option to provide skin and soft tissue coverage in select cases of hypospadias and beyond.