Multi-stage repair surgery in combination with hormonal therapy for scrotal hypospadias with severe chordee, micropenis, and bifid scrotum

Abstract Proximal hypospadias includes proximal penile, penoscrotal, scrotal, and perineal types, which are a less frequent occurrence and correspond to 20% of total hypospadias. Surgical reconstruc- tion is the only possible therapeutic option for hypospadias. The primary objectives of the recon- struction are to create a vertically slit orthotopic meatus, straighten the penis and establish good cosmetic results that include a conically shaped glans. Other essential aspects of the reconstruc- tion are to avoid shortening the penis and optimal skin coverage. This study reports a case with abnormal spraying during urination. Severe forms of hypospadias are typically accompanied by an abnormal ventral curvature of the penis (chordee). Surgical correction of both chordee and hypospadias is recommended. When adequately corrected, it does not cause long-term problems, and a natural appearance of the penis is usually restored. Keywords: Scrotal hypospadias, severe chordee, micropenis, bifid scrotum, cordectomy ortho- Plasty, urethroplasty, scrotoplasty