Correction of penile torsion and chordee by mobilization of urethra with spongiosum in chordee without hypospadias A. Bhat a, *, K. Sabharwal a , M. Bhat b , M. Singla a , V. Kumar a , R. Upadhyay a a Department of Urology, S.P. Medical College, Bikaner, Rajasthan, 334003, India b Department of Preventive and Social Medicine, S.P. Medical College, Bikaner, Rajasthan, 334003, India Received 16 March 2014; accepted 20 June 2014 KEYWORDS Congenital anomaly; Chordee without hypospadias; Penile torsion; Correction; Mobilization of urethra and urethral plate; Glanuloplasty Abstract Objective: To investigate the feasibility of correcting coexistent penile torsion and chordee without hypospadias by mobilization of the urethra and spongiosum. Materials and Methods: A retrospective study of nine patients with simultaneous penile torsion and chordee without hypospadias was undertaken between January 2006 and December 2012. During this period, a total of 364 cases of hypospadias and 38 of chordee without hypospadias were operated on, making a total of 402 patients with hypospadias-related complexes. The same steps were used for correction of both torque and chordee. After a circumcoronal inci- sion, the penis was fully degloved and the spongiosum with urethra was lifted up off the caver- nosa. Next, mobilization of the hypoplastic urethra with spongiosum was extended into the glans. If chordee or torque persisted, urethral mobilization was performed proximally up to the bulbar urethra, as required. Spongioplasty and glansplasty were done and a per-urethral stent was kept in for three to five days. Results: The age of the patients ranged from 5 to 16 years (median 6 years). Penile torsion ran- ged from 30  to 120  , with a median of 75  . Ventral chordee ranged from 45  to 100  , with a median of 50  . A ratio of 1:9.6 was found for chordee without hypospadias compared to the total hypospadias cases, with an incidence of 9.5%. The ratio of chordee without hypospadias with torsion compared to the total hypospadias cases was 1:29. There was an incidence of chordee without hypospadias with penile torsion of 3.5% in all patients with hypospadias. The ratio of chordee without hypospadias with torsion to only chordee without hypospadias was 1:1.71, with an incidence of 37.0%. Every step contributed to the correction of curvature and torsion. Chordee was corrected in two patients by penile degloving and lifting of the * Corresponding author. C-15 Sadul Ganj, Bikaner, Rajasthan, 334003, India. Tel.: þ91 151 2226327. E-mail addresses: amilalbhat@rediffmail.com, bhatamilal@gmail.com, amilalbhat@hotmail.com (A.Bhat), drkvsabharwal@gmail.com (K.Sabharwal), mahak199027@gmail.com (M.Bhat), drmanishsingla@gmail.com (M.Singla), vinaysinghkgmc99@gmail.com (V.Kumar), surgeon.ups@gmail.com (R.Upadhyay). + MODEL Please cite this article in press as: Bhat A, et al., Correction of penile torsion and chordee by mobilization of urethra with spongiosum in chordee without hypospadias, Journal of Pediatric Urology (2014), http://dx.doi.org/10.1016/j.jpurol.2014.06.016 http://dx.doi.org/10.1016/j.jpurol.2014.06.016 1477-5131/ª 2014 Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company. Journal of Pediatric Urology (2014) xx,1e6