Correction of distal hypospadias with reconstruction of the preputium.

The method described deals mainly with a method of redistributing the skin after reconstruction of the urethra. The rationale for the operation is based on the pathologic embryology of the deformity. The technique is used in distal penile and glanular hypospadias in the absence of chordee. The meatus is relocated with a distally based turnover flap or with a meatoplasty and glanuloplasty. The lateral fusion raphes, which bifurcate in hypospadias from the ventral raphe toward the dogears of the skin hood, are then opened and sutured longitudinally, as fusion should have occurred. The postoperative aspect is that of a normal prepuce. Postoperative swelling is almost nonexistent, the incisions being made in embryologic fusion raphes. Results have been especially pleasing from the aesthetic point of view. A "functional" mobile prepuce is obtained (Table I).