Abstract
A thorough evaluation of both urethral and penile malformation are mandatory for the choice of the best surgical treatment of patients with hypospadias. The site and the size of the urethral meatus, the presence of a chordee and of a velamentous distal urethra must be carefully assessed. In distal (glandular and coronal) hypospadias, the meatal advancement with glanduloplasty is the treatment of choice. In proximal hypospadias with chordee, the transverse preputial island flap according to the Duckett's technique allows a one-stage hypospadias repair. The awareness of the possible psychologic impact of genital malformations in childhood recommends an early correction of hypospadias, if possible during the first year of life.
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