[Experience with one stage repair of hypospadias and chordee without hyposradias using free graft of prepuce].

We treated 14 patients with moderately severe hypospadias and chordee without hypospadias using a free graft of prepuce by a modified Devine-Horton technique, between September 1993 and April 1995. There were 12 primary cases and 2 secondary cases in which prior operations had already been done. Four (33%) of the primary cases required a second procedure; 3 for urethrocutaneous fistula and 1 for urethral shrinkage. Both of the secondary cases needed further procedures; 1 for meatal stenosis and 1 for urethral stricture and diverticula. Although the need for reoperation is unfortunately high, six of the 7 recently treated patients experienced no complications. Thirteen of the 14 patients (93%) achieved excellent functional and cosmetic results with 1 or 2 procedures. We believe the use of free grafts allows a better functional and cosmetic outcome because the secondary torsion and bulkiness of the penile shaft caused by a vascular pedicle are eliminated.