title: Ventral corporal body grafting for correcting severe penile curvature associated with single or two-stage hypospadias repair.
abstract: OBJECTIVE
  The literature on small intestinal submucosa for chordee correction in children is scarce. We reviewed our experience with 1 ply SIS for ventral corporal body grafting in cases of severe ventral penile curvature associated with proximal hypospadias in children.
  
  
  METHODS
  From 04-2001 to 12-2007, 58 boys with proximal hypospadias and severe ventral curvature underwent single layered SIS graft to the corporal bodies to correct chordee. In 43 patients the surgery was done in the first stage of a planned 2-stage procedure. Fifteen patients underwent a 1-stage chordee correction with SIS and tubularized transverse preputial flap urethra.
  
  
  RESULTS
  Mean follow-up was 4.8 years. A straight phallus with good cosmesis was achieved in 57/58 patients. In 51/58 patients an artificial erection was performed in the operating room as part of a second stage procedure or for complications associated with the one stage urethroplasty. One patient needed a second procedure to correct the curvature (chordee was over-corrected and needed a ventral Nesbitt plication). In fifteen patients that underwent a 1-stage genital reconstruction, the neourethral meatus was left in the lower part of the glans in 8 patients and at the coronal sulcus in 7.
  
  
  CONCLUSIONS
  Corporal body grafting with single layer SIS is a viable option for correction of severe chordee associated with corporal body disproportion. SIS is a material with reliable results, easy availability and no donor site associated morbidity. As a result of penile elongation with a graft, simultaneous island flap urethroplasty became difficult in many patients.
authors.affiliation: Division of Pediatric Urology, Miami Children's Hospital, Jackson Memorial Hospital, University of Miami, Miami, FL, USA. miguel.castell@gmail.com
authors.forename: Miguel
authors.initials: M
authors.lastname: Castellan
authors.forename: Castellan
authors.initials: C
authors.lastname: Miguel
authors.forename: Rafael
authors.initials: R
authors.lastname: Gosalbez
authors.forename: Gosalbez
authors.initials: G
authors.lastname: Rafael
authors.forename: Joshi
authors.initials: J
authors.lastname: Devendra
authors.forename: Devendra
authors.initials: D
authors.lastname: Joshi
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bar-Yosef
authors.forename: Bar-Yosef
authors.initials: BY
authors.lastname: Yuval
authors.forename: Andrew
authors.initials: A
authors.lastname: Labbie
authors.forename: Labbie
authors.initials: L
authors.lastname: Andrew
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007223:Infant; D007413:Intestinal Mucosa / Q000637:transplantation*; D008297:Male; D010413:Penis / Q000002:abnormalities* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013521:Urologic Surgical Procedures, Male / Q000379:methods*