Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty

Abstract Background Deficient ventral prepuce is a rare anomaly of prepuce with normally situated meatus. It is usually associated with this or hypoplastic urethra. Methods A retrospective study included all infants diagnosed with a ventrally hooded prepuce. A penile degloving was the first step. Th...

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Main Author: Mazen O. Kurdi
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Urology
Online Access:https://doi.org/10.1186/s12894-025-01699-6
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author Mazen O. Kurdi
author_facet Mazen O. Kurdi
author_sort Mazen O. Kurdi
collection DOAJ
description Abstract Background Deficient ventral prepuce is a rare anomaly of prepuce with normally situated meatus. It is usually associated with this or hypoplastic urethra. Methods A retrospective study included all infants diagnosed with a ventrally hooded prepuce. A penile degloving was the first step. Then reinforcement of the hypoplastic urethra by spongioplasty was performed. Sleeve resection of the hooded prepuce and reconstruction of sulcus corona was the last step. Results The mean operative time was 44 ± 9.5 min. A hypoplastic urethra was reported in 35 cases (30.4%). A urethral stent was inserted at the beginning of the procedure and removed at the end. Twelve patients (10.4%) developed urethral cutaneous fistulas by the end of the first postoperative month. Conclusion A hooded ventral prepuce with ventral chordee and normally situated meatus presents a challenge for paediatric surgeons. It is usually associated with a hypoplastic urethra. Attempts should be made to correct the chordee and preserve the urethra. The preserved urethra can be reinforced with spongioplasty. Unintended urethral injuries are common during dissection. Therefore, repairing the injury, reinforcing the dartos pedicle flap, and spongioplasty are suitable options. It is possible to preserve the urethra in patients having chordee without hypospadias. Utmost care should be taken to avoid urethral injuries which are common because shaft skin is stuck to the urethral skin. Urethral injuries can be repaired primarily; however, there is a high incidence of fistula.
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spelling doaj-art-d15d9ab1f2ac472ca5a42c722e1461bf2025-02-09T12:56:16ZengBMCBMC Urology1471-24902025-02-0125111210.1186/s12894-025-01699-6Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplastyMazen O. Kurdi0Division of Pediatric Surgery, Department of Surgery, King Abdulaziz University Hospital, faculty of medicine, King Abdulaziz UniversityAbstract Background Deficient ventral prepuce is a rare anomaly of prepuce with normally situated meatus. It is usually associated with this or hypoplastic urethra. Methods A retrospective study included all infants diagnosed with a ventrally hooded prepuce. A penile degloving was the first step. Then reinforcement of the hypoplastic urethra by spongioplasty was performed. Sleeve resection of the hooded prepuce and reconstruction of sulcus corona was the last step. Results The mean operative time was 44 ± 9.5 min. A hypoplastic urethra was reported in 35 cases (30.4%). A urethral stent was inserted at the beginning of the procedure and removed at the end. Twelve patients (10.4%) developed urethral cutaneous fistulas by the end of the first postoperative month. Conclusion A hooded ventral prepuce with ventral chordee and normally situated meatus presents a challenge for paediatric surgeons. It is usually associated with a hypoplastic urethra. Attempts should be made to correct the chordee and preserve the urethra. The preserved urethra can be reinforced with spongioplasty. Unintended urethral injuries are common during dissection. Therefore, repairing the injury, reinforcing the dartos pedicle flap, and spongioplasty are suitable options. It is possible to preserve the urethra in patients having chordee without hypospadias. Utmost care should be taken to avoid urethral injuries which are common because shaft skin is stuck to the urethral skin. Urethral injuries can be repaired primarily; however, there is a high incidence of fistula.https://doi.org/10.1186/s12894-025-01699-6
spellingShingle Mazen O. Kurdi
Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty
BMC Urology
title Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty
title_full Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty
title_fullStr Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty
title_full_unstemmed Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty
title_short Chordee and hooded prepuce with no hypospadias; outcome of urethral preservation surgery with spongioplasty
title_sort chordee and hooded prepuce with no hypospadias outcome of urethral preservation surgery with spongioplasty
url https://doi.org/10.1186/s12894-025-01699-6
work_keys_str_mv AT mazenokurdi chordeeandhoodedprepucewithnohypospadiasoutcomeofurethralpreservationsurgerywithspongioplasty