Two-stage versus single-stage repair for severe hypospadias with moderate chordee

Abstract

Introduction Modern approach in hypospadias repair is to preserve the urethral plate if possible. The aim of the current study was to compare the final outcome for repair of severe hypospadias with moderate chordee using single-stage Snodgrass repair versus two-stage repair with dermal graft corporoplasty and to measure the degree of parent’s satisfaction for both procedures. Patients and methods A retrospective review was performed for all cases of severe hypospadias during the period from February 2006 to February 2013. Cases of severe hypospadias were defined as proximal penile, penoscrotal, and scrotal. Moderate chordee was defined as a chordee between 30 and 508. Exclusion criteria included chordee more than 508, perineal hypospadias, and cases in whom the chordee was corrected by division of the urethral plate. Two-stage repair was performed with dermal graft corporoplasty and single-stage repair was performed using Snodgrass repair.
Results A total of 39 patients were included in the study. The mean age at surgery for single-stage repair was 18 months versus 21 months for the two-stage repair. There was statistically significant less duration for completion of the surgical procedures for single-stage repair. Postoperative complications were 47 versus 12.5% for single-stage and two-stage repair, respectively, which was statistically significant. There was statistically significant better parents’ satisfaction for the two-stage repair.
Conclusion Repair of severe hypospadias with moderate chordee using two-stage dermal graft corporoplasty was associated with statistically significant less postoperative complications and more parents’ satisfaction than singlestage Snodgrass urethroplasty repair.