A 1.5 years old boy was referred to us from Goa with severe hypospadias and chordee, diagnosed as scrotal hypospadias with chordee. The urinary opening was near the end of the scrotum. The penis was also significantly bent (chordee). Since our center specializes in single-stage urethroplasty, we decided to do a single-stage repair, specifically Child Severe Hypospadias Koyanagi urethroplasty.
As a first step, the penis was degloved and the chordee was corrected using 12 O’clock tunica plication. The Koyanagi flaps were raised on either side, going on the top of the penis, and these were then joined together in the midline and finally tubularized using 6-0 PDS over 8 Fr stent.
Second layer coverage was done with Tunica Vaginalis flap and prepuce on top was split in midline and brought ventrally or coverage of skin. The child did very well and required no further surgery.