title: Chordee without hypospadias: complications and management of the hypoplastic urethra.
abstract: The surgical correction of chordee without hypospadias may be difficult and result in significant intraoperative and postoperative complications, especially when there is an associated hypoplastic type I urethra. Between 1981 and 1985 we treated 13 patients with this condition. Of the cases 9 had a type I urethra, 3 had type II and 1 had type III, according to the Devine-Horton classification. Postoperatively, glanular tilt persisted in 3 patients, ventral tethering was present in 2 and a fistula developed in 2, for a 54 per cent complication rate. Of the 7 complications 5 occurred in type I cases. Complications may arise from preserving or attempting to preserve a thin hypoplastic urethra. When the paper-thin type I urethra is associated with an abnormal meatus, the entire dysplastic urethra should be reconstructed. If the meatus is normal, clinical judgment must dictate which type I urethras may be preserved and which must be reconstructed.
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias; D007223:Infant; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008722:Methods; D010409:Penile Diseases / Q000601:surgery*; D010413:Penis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D014521:Urethra / Q000601:surgery*