There are four forms of chordee that do not involve hypospadias: cutaneous chordee, fibrous chordee, corporocavernosal chordee, and congenital short urethra. From 1981 to 199i, 214patients aged 18months to 20 years underwent surgical treatment. Among these, 29 individuals developed a crippled penis due to the failure of surgery for the hypospadias sine hypospadias anomaly. This report describes the surgical repair of hypospadias sine hypospadias, whereby the operative approach is closely related to the type of anomaly involved and should thus be highly individualized. The rate of complications encountered in the present study was 11.2O7o.In hypospadias sine hypospadias, the urethral meatus is positioned normal in the glans and the prepuce is usually abnormal in configuration, but the penis is curved ventrally. Chordee is due to an abnormality in the development of the penis. Four varieties of chordee occur depending on the specific tissue involved.In so-called cutaneous chordee, the urethra and corpus spongiosum show normal development, with dysgenetic and inelastic tissue occurring in the dartos and, to an extent, Buck's fascia layers. Simple mobilizing of the skin of the penile body in the layers of dartos and Buck's fascia enables the straightening of the penis. In fibrous chordee, a fibrous tissue derived from Buck's and dartos fascias lies deep and lateral to the partially abnormally developed corpus spongiosum. In such cases the excision of all fibrous tissue, the so-called chordectomy, straightens the penis. In corporoeavernosal chordee, the corpus spongiosum and fascial layers may be normally or abnormally developed, but shortness or inelasticity of the tunica albuginea of the corporal bodies is evident, usually in the ventral aspect. These changes in the tunica itself may be repaired by plication or excising ellipses of the dorsal tunica albuginea (dorsal corporoplasty). In congenital short urethra, epithelial urethra lies beneath a thin layer of skin. Dysgenetic fibrous tissue represents a lack of development of the corpus spongiosum and of Buck's and dartos fascias. Straightening of the penis is achieved by resection of the urethra and excision of the fibrous tissue. Some cases involve an association of fibrous chordee, corporocavernosal chordee, and congenital short urethra. A successful repair of curvature in such patients is accomplished only by a combination of chordectomy, dorsal corporoplasty, and resection of the urethra.According to the classification of Devine and Horton [4], cutaneous chordee corresponds to type III; fibrous chordee, to type II; corporocavernosal chordee, to type IV; and congenital short urethra, to types 1 and ¥.
Hypospadias sine hypospadias cripple is an iatrogenicanomaly that results from the failure of surgical repairs. The features of this disorder include changes in the shape and function of the penis along with curvature, fistulas, stenosis, and damage to the prepuce and penile skin.
Patients and methodsFrom 1981 to 1991, a total of 214 patients underwent treatment for...
