Dorsal Corporeal Rotation: An Alternative Technique for the Management of Severe Chordee

Abstract

Chordee with or without hypospadias is usually managed successfully in a fairly straightforward manner. However, on occasion there are patients with severe chordee that cannot be corrected with the standard techniques. In this setting tunica vaginalis grafts, dermal grafts and Nesbit plication techniques have been used but all of these procedures have major drawbacks. During the last 5 years we have used an alternative technique for the correction of severe ventral curvature that persists despite complete resection of fibrous chordee. This technique combines a deep vertical incision between the corporeal bodies ventrally with a series of transverse dorsal plicating sutures to correct chordee. There is no incision into the corporeal bodies and no shortening of the penis as with the Nesbit technique, and potential injury to the neurovascular bundles is minimized. Followup 1 to 5 years later in 6 patients confirms satisfactory chordee correction in all cases.