The selective use of a single-stage and a two-stage technique for hypospadias correction in 157 consecutive cases with the aim of normal appearance and function.

Summary This paper establishes the aim of normal function and appearance in hypospadias surgery. In order to meet this aim we have used a combination of a single-stage and a two-stage repair, both incorporating foreskin reconstruction. The technique of single-stage repair is illustrated using operative photographs. Our experience with 157 repairs in a 3-year period is described. Thirty-five single-stage repairs were completed with no complications; 122 two-stage repairs were carried out, in which a 5% fistula rate was achieved in primary cases. Salvage reconstruction had a higher incidence of complications.