title: [Operative methods for severe hypospadias].
abstract: BACKGROUND
  Pediatric urologists tend to use one-stage procedures for the repair of hypospadias. As there are various types of hypospadias, we cannot repair this disease with a single modality. It is difficult to estimate the exact length of the neourethra in cases of severe hypospadias before surgery.
  
  
  METHODS
  After a circumferential incision is made about the coronal sulcus and the chordee is completely released, the distance between the glans tip and the retreated native meatus is measured to determine the length of the neourethra. Urethroplasty with the method of Transverse Preputial Island Flap (TPIF) is selected when the distance ranges from 3 to 4 cm, while urethroplasty using with modified OUPF IV (Koyanagi) is selected in cases of more than 4 cm.
  
  
  RESULTS
  We performed surgery on 14 hypospadiac patients with chordee between April 1996 and April 1997. Eight patients underwent urethroplasty using the TPIF method and 6 underwent urethroplasty with the method of the modified OUPF IV. With the TPIF methods, 7 to 8 patients underwent repair successfully and one experienced urethrocutaneous fistula, while 5 of 6 treated by the modified OUPF IV method has successful repairs and meatal stenosis occurred in one patient.
  
  
  CONCLUSIONS
  Even if we encounter severe hypospadias, we can treat these patients with one stage repair alternatively. A relatively high success rate was obtained with both methods to repair severe hypospadias.
authors.affiliation: Department of Urology, Nagoya City University Medical School.
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Maruyama
authors.forename: Y
authors.initials: Y
authors.lastname: Kojima
authors.forename: H
authors.initials: H
authors.lastname: Senzaki
authors.forename: N
authors.initials: N
authors.lastname: Asai
authors.forename: M
authors.initials: M
authors.lastname: Azemoto
authors.forename: M
authors.initials: M
authors.lastname: Mogami
authors.forename: T
authors.initials: T
authors.lastname: Mogami
authors.forename: K
authors.initials: K
authors.lastname: Kohri
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D008297:Male; D013524:Surgical Flaps; D013521:Urologic Surgical Procedures, Male / Q000379:methods*