title: Lengthening the urethral plate with a double flap technique: a new procedure for correction of primary hypospadias with chordee.
abstract: OBJECTIVE
  We describe a new 1-stage technique for the surgical treatment of primary hypospadias with chordee dividing the urethral plate into 2 flaps.
  
  
  METHODS
  The urethral plate is divided into 2 flaps in an oblique fashion. Penis straightening is achieved with resection of the fibrous ventral tissue after mobilization of the plate. The ventral side of the neo-urethra is harvested from the preputium penis with an onlay island flap or penile skin with the Mathieu "flip-flap" procedure.
  
  
  RESULTS
  The new 1-stage procedure has been used in 6 patients. After 10-month followup a fistula developed in only 1 patient who required a new surgical procedure for correction. No meatal stenosis or urethral stricture was noticed. No dorsal plication sutures were required. All 6 patients who underwent a successful procedure had excellent cosmetic results.
  
  
  CONCLUSIONS
  This technique is a valid surgical option in patients with hypospadias with severe chordee when we believe that the short plate tethers the penis, avoiding adequate straightening.
authors.affiliation: Department of Pediatric Surgery, Section of Pediatric Urology, Children's Hospital Teresa Herrera, Complexo Hospitalario Juan Canalejo, A Coruña, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Vela
authors.forename: Roberto
authors.initials: R
authors.lastname: Méndez
authors.forename: Manuel G
authors.initials: MG
authors.lastname: Tellado
authors.forename: Iván
authors.initials: I
authors.lastname: Somoza
authors.forename: Jorge
authors.initials: J
authors.lastname: Liras
authors.forename: Ernesto
authors.initials: E
authors.lastname: Pais
mesh_terms: D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D008297:Male; D010413:Penis / Q000473:pathology*; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*