Response to editorial comment Re: ‘Urethral strictures following urethral plate and proximal urethral elevation during proximal TIP hypospadias repair’

Abstract

When will hypospadiologists finally abandon the concept that “chordee tissues” cause ventral penile curvature? This idea arose in the 1950s when “chordee” became synonymous with both ventral curvature and the fibrous tissues presumed responsible for that curvature. In an era before the urethral plate was recognized, or artificial erection described, the epithelium extending from the meatus to the glans in hypospadias was understood to cover contracted fibrous tissues that produced curvature and had to be meticulously excised for straightening. However, Devine and Horton, and John Duckett, among others, found curvature often persisted despite thorough excision of all ventral tissues to the tunica albuginea, indicating these cases had corporal disproportion as the underlying etiology for bending. Re. ‘Urethral strictures following urethral plate and proximal urethral elevation during proximal TIP hypospadias repair’Journal of Pediatric UrologyVol. 10Issue 3PreviewMollard et al. [1–3] proposed a revolutionary idea in treatment of patients with proximal hypospadias by the use of an onlay island flap [4] on a preserved urethral plate. But, the first release of chordee by mobilization of the urethral plate with resection of the underlying fibrous tissue was proposed by Koyanagui in 1983 [5]. Full-Text PDF