Technical aspects of the Koff procedure (urethral mobilization) in anterior hypospadias

Abstract

In our center the level of division of the corpus spongiosum as the determinant to classifying hypospadias. The hypospadias with a distal division is less severe and they present a little curvature. We present a case of distal hypospadias corrected by Koff technique and we showed our tricks for avoiding curvature. In this selected case a Koff procedure are preferred because it has the main advantage of exicing the dysplastic tissues and avoiding a urethroplasty using nonurethral tissues. Late penile curvature is a source of concerns for some, but in our experience no significant curvature was found at follow up. We believe that some tricks, showed in our video, are necessary to avoid iatrogenic curvature and to obtain a good cosmetic result. Koff technique is a good technique for hypospadias with distal division of corpus spongiosum, without significant curvature at follow up.