Reverse tumble flap with tubed island-flap urethroplasty for hypospadias or chordee without hypospadias.

From July 1971 to April 1979, 47 children who required detachment of the meatus from more distal tissues for adequate chordee release or who needed division of the urethra underwent a 1-stage tubed island-flap procedure. In this procedure the dorsal surface of the hooded prepuce is used to form a urethral tube and the ventral surface is used for shaft skin coverage. In followup to 5 years our long-term functional and cosmetic results appear acceptable for situations requiring creation of only a moderate length of urethra. For more proximal hypospadias a high complication rate has discourged our continued use of this 1-stage procedure.