title: Correction of Residual Ventral Penile Curvature After Division of the Urethral Plate in the First Stage of a 2-Stage Proximal Hypospadias Repair.
abstract: OBJECTIVE
  The first stage of a 2-stage proximal hypospadias repair involves division of the urethral plate and correction of any residual ventral penile curvature (VPC). Options to correct residual VPC include dorsal corporal shortening or ventral corporal lengthening techniques. This review discusses these options and suggests an approach to management.
  
  
  RESULTS
  Recent reports of 2-stage proximal hypospadias repairs indicate low rates of recurrent VPC with either dorsal corporal shortening or ventral corporal lengthening. Dorsal corporal shortening with dorsal plication may be preferentially used for mild to moderate residual VPC after division of urethral plate and ventral corporal lengthening reserved for severe residual VPC. Ventral corporal lengthening with grafts has been associated with urethroplasty complications after the second stage hypospadias surgery. Ventral corporal lengthening with relaxing incisions of corpora has been reported, but concerns about adverse effects require longer term studies. Little guidance exists to choose the best technique for VPC correction during first stage hypospadias repair after division of urethral plate. Reported literature suggests good results with dorsal plication techniques and ventral corporal lengthening. A practical approach is to use dorsal plication techniques for mild to moderate residual VPC after division of urethral plate (<45°) and reserve ventral corporal lengthening for severe residual VPC (>45°).
authors.affiliation: Department of Urology, University of Texas Southwestern, 2350 Stemmons Freeway, Suite D-4300, MC F4.04, Dallas, TX, 75207, USA. bruce.schlomer@childrens.com.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Schlomer
mesh_terms: D000818:Animals; D006801:Humans; D007021:Hypospadias / Q000601:surgery; D008297:Male; D010413:Penis / Q000601:surgery*; D013524:Surgical Flaps; D014521:Urethra / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods
keywords: Chordee; Corporal graft; Dorsal plication; Hypospadias; Penile curvature; Proximal hypospadias