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 hypospadias it was the only procedure used. In 10 with proximal hypospadias, it was combined with other techniques. In distal hypospadias, no postoperative fistula occurred. Complications of the operation were 3 meatal stenoses that responded to dilatation, 1 urethral injury immediately repaired with no consequent fistula, and 1 chordee that was subsequently corrected. Of the 10 children with proximal hypospadias, 3 developed minor fistulae and 1 meatal stenosis. Urethral mobilization was found to be a safe and effective procedure in the management of hypospadias. It could be the only procedure required in distal hypospadias, or in combination with other procedures in proximal hypospadias.