Urethral mobilization and meatal advancement: a surgical principle in hypospadias repair

A technique of urethral mobilization and advancement in hypospadias repair using the urethral elasticity to partially or completely bridge the defect in urethral length was employed in 56 children. In 46 with distal hypospadi as it was the only procedure used. In 10 with proximal hypospadias, it was combined with other techniques. In distal hypospadias,no postoperative fist ula occurred. Complications of the operation were 3 meatal stenoses that re sponded to dilatation, 1 urethral injury immediately repaired with no conse quent fistula, and I chordee that was subsequently corrected. Of the 10 chi ldren with proximal hypospadias, 3 developed minor fistulae and 1 meatal st enosis. Urethral mobilization was found to be a safe and effective procedur e in the management of hypospadias. It could be the only procedure required in distal hypospadias, or in combination with other procedures in proximal hypospadias.