Cecil Urethroplasty with Concurrent Scrotoplasty for Repair of Hypospadias

Abstract

During 13 years about 8 per cent of 234 patients operated upon for hypospadias presented surgical problems of reconstruction of the urethra from the urethral meatus proximal to the penoscrotal junction. These cases commonly are referred to as perineal or penoscrotal hypospadias. The problem occurs when the urethral groove fails to develop adequately and the scrotal folds have failed to rotate caudally. This hypospadias is in contrast to penoscrotal or distal hypospadias, when the urethral groove is developed but fusion is incomplete. In these patients the Cecil procedure has been used but modified to extend the urethra from behind the penoscrotal junction to the glans at the second stage of the urethroplasty. The modification consists of rotating the scrotum caudally from its high location. The tension and acute angulation that contributed to frequent complications previously associated with such attempts have been avoided and results are satisfactory.

One-Stage Repair of Perineal Hypospadias and Scrotal Transposition

“…This was based on the rationale that in distal to penoscrotal hypospadias the urethra itself does not contribute to chordee deformity once shaft 'degloving' was accomplished by dartos mobi lization [4]. Proximal to penoscrotal hypospadias, as in the present case, the urethra must be severed and de tached from the glans because it is often atretic and by itself contributes significantly to the formation of chordee deformity [5]. Notwithstanding this difference, it may be argued that our method of urethroplasty is similar to what has been described by Broadbent et al [6] or DesPrez et al [7], but it is done in a more extended form and bilateral fashion in creating the parameatal pedicle flap.…”