[Interest of mobilization of the urethral plate in the release of chordee related to posterior hypospadias].
OBJECTIVE: To compare the advantages of release of the skin and dartos to those obtained after mobilization of the urethral plate and resection of the underlying fibrous tissue (according to Mollard). MATERIAL AND METHODS: Between February 1996 and March 2003, 97 patients were operated for posterior hypospadias. Lateral photographs were taken in these patients during successive erection tests: a first test was performed at the beginning of the operation, a second test was performed after release of the skin and dartos, a third test was possibly performed after mobilization of the urethral plate and resection of the underlying fibrous tissue, and a last test was performed at the end of the operation. RESULTS: Release of chordee with preservation of the urethral plate was achieved in 88 patients (91% of cases). Analysis of the lateral photographs showed that dissection of the skin and dartos ensured correction of chordee less than 55 degrees, while this procedure was insufficient for chordee exceeding 90 degrees. Dissection of the urethral plate and resection of the underlying fibrous tissue only allowed correction of chordee between 10 degrees and 25 degrees, with no increase of the postoperative complication rate. CONCLUSIONS: Correction of chordee associated with posterior hypospadias is essentially obtained by release of the skin and dartos and mobilization of the urethral plate does not endanger the blood supply.