Observations upon techniques for reconstruction of the urethral meatus, the hypospadiac glans deformity and the penile urethra

Many minimal defects of the terminal urethra may be left untreated; others may be considerably improved by a simple one-stage extension to a terminal position by one of the many one-stage "flap-strip" procedures. Patients with a marked ventriflexed glans are much better treated by the "kippered-glans" procedure; undertaken as a two-stage procedure, the functional and the cosmetic results of this procedure are extremely good and reliable. The results of one-stage procedures reflect the experience and the judgement of the surgeon but they tend to be less perfect and furthermore there is always an element of "double or quits" inasmuch as complications may require revision procedures. Thus a minor surgical dilemma arises because both the cosmetic and the functional results of a two-stage "kippered-glans" procedure for severe hypospadiac deformities tend to be better than those achieved for minor deformities by one-stage flap-strip or glans-flap procedures.