Surgical techniques
chordee, hypospadias, penile chordee
MINOR, URETHRA, LEAKAGE
Different procedures were used in surgical repair of hypospadias according to meatal site, availability of prepuce, quality of urethral plate, the presence of chordee and surgeon preference. Tubularized incised plate (TIP) urethroplasty as described by Snodgrass [In cases with penile chordee, we started with complete degloving of the penile shaft in the plane between dartos and Buck’s fascia, then checking with artificial saline injection. The chordee was corrected either by dorsal plication of tunica albuginea, urethral plate mobilization, or urethral plate transection.At the end of surgical procedure after finishing all sutures, one ml of long acting corticosteroid (containing 4 mg of betamethasone) was added to 1 ml of saline then it was locally injected in group A using insulin syringe (1 ml 31 gauges). In each case, we used to inject from 1 to 1.5 ml of the diluted betamethasone according to penile size. Betamethasone was injected just beneath the skin (in Dartos fascia) 2 ml proximal to coronal sulcus in twelve to sixteen spots all around the coronal sulcus and proximally to distribute it as much as we can, we compressed the injection site for 30 s to avoid leakage of the injected betamethasone. We spared the ventral area around the urethra from 5 to 7 o’clock to avoid any possible effect of the corticosteroid on the healing of the urethral suture line. (Supplementary Fig. 2) We used minor compressive dressing in all cases of our study and we kept it for 48 h.All procedures were done under general anesthesia. Prophylactic intravenous antibiotic was given to all cases half an hour preoperatively.