Superficial location of fivrous bands causing chordee in patients with penoscrotal hypospadias has been demonstrated by microscopic and gross photographs. Our technique to manage this problem is similar to that described by Allen and Spence and by King for distal hypospadias and has been used in 120 patients. The technique involves the repair of the embryologic penile defect by advancing the closure of the urethral groove and transposing the scrotum to its appropriate caudal position. The repair is applicable in patients with failure of fusion rather than failure of the development of the urethral groove as in perineal hypospadias.

In any case of intra-abdominal trauma or hemorrhage a preoperative IVP is essential to determine the renal status. Preoperative catheter occlusion of the renal artery in these vascular tumors may be attempted to decrease blood loss. Stigmas of tuberous sclerosis should be sought in patients with vascular renal tumors, especially if they are bilateral. Conservation of renal tissue in tuberous sclerotic patients harboring renal angiomyolipomas is important.

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