STAGED RECONSTRUCTION OF HYPOSPADIAS WITH CHORDEE - OUTCOME AND COSTS

One-hundred-and-fort patients with hypospadias and chordee were review ed from the points of view of surgical results and hospital costs. Nin ety cases constituted a historical series, and 50 patients a current p ersonal series. All were operated on by Byars' two-staged protocol wit h release of the chordee followed by urethral reconstruction. Compleme ntary surgery was necessary in a total of 37 instances, particularly i n cryptohypospadias with tight chordee and in penoscrotal hypospadias. Increasing personal experience with the operative technique has gradu ally reduced the need for such procedures. The final results were sati sfactory in all but one patient, who has had recurring strictures. The hospital cost for a patient according to basic assumptions was 100 28 0 SEK (about US$ 14 000). if the time in operating theatre could be sh ortened by 10 minutes, the stay in hospital reduced by one day, and th e complication rate halved, the overall cost would be reduced by 14.3% . Consequently we believe that staged reconstruction remains an attrac tive alternative in cases of hypospadias with marked curvation of the penis.