Distal Hypospadias Repair: Experience with Corpus Spongiosum Advancement

Objective: Corpus spongiosum advancement technique has been used for repair of glanular, coronal and distal penile hypospadias without chordee. A brief description of the procedure and operative outcome has been described with discussion of relevant literature. Methods: Out of 112 patients aged 12 to 126 months, operated between July 2009 and December 2013, 54 had coronal, 38 had glanular and 20 had distal penile hypospadias. None of the patients had chordee. All patients underwent advancement of corpus spongiosum. Results: The mean operating time was 32 minutes and mean blood loss was 15 ml. In 8 patients, the spongiosum was opened inadvertently during dissection. It was repaired with 5-0 vicryl and stitched to the cavernosal bed. Three of them were kept on catheter drainage for 5 days. Mean hospital stay was 0.5days (06 days). Eighty eight patients were discharged on the day of surgery and 21 patients needed admission for a day, as they came from far off places. There were no operative complications. Functional and cosmetic outcome has been found to be satisfactory in all the patients. Three patients with distal penile hypospadias developed meatal stenosis, 2 of them did well with meatal dilatation, but 1 patient needed meatoplasty. The mean follow up period was 24.5 months (4 months to 53 months). Conclusion: Corpus spongiosum advancement is an ideal technique for glanular and coronal hypospadias and associated with excellent functional and cosmetic outcome. However, cases of distal penile hypospadias should be carefully selected to achieve good results.