Concepts for correction of penile hypospadias

The repair of penile hypospadias encompasses correction of the penile curvature, urethral reconstruction, glanuloplasty, and coverage of the penile shaft with skin. A straight penis can be achieved by chordectomy alone or in combination with a dorsal plication technique (Nesbit and modifications). For urethral reconstruction, pedicled foreskin flaps, incision of the urethral plate with subsequent tubularization (Snodgrass, TIP procedure) as well as free buccal mucosa onlays have been used. The operative technique of the respective procedures with their results obtained are described and discussed. The pedicled onlay flap with a complication rate of up to 22% in larger series is the most commonly used technique. Comparable results can be obtained with the free buccal mucosa graft. Long-term data are lacking for final evaluation of the TIP procedure published by Snodgrass.