The GUD technique: Glandular urethral disassembly for distal hypospadias repair

      Summary

      Introduction

      We present an alternative procedure for distal hypospadias consisting of urethral mobilization and glandular disassembly, named GUD-technique.

      Material and methods

      After circumcision and exposure of distal dysplastic urethra, it is entirely mobilized from corpora and glans. Glans is deconstructed and incised in midline producing two wings almost not connected to glandular urethra at all. The urethra is then mobilized cranially and sutured to the tip of glans. Glans wings embrace the distal urethra producing a refurbished conical glans.

      Discussion

      Koff et al. published a technique consisting of extensive urethral mobilization for hypospadias repair. Mitchell & Blagi and Perovic et al. reported on complete penile disassembly for epispadia repair as a way to complete release of the rotation of the penis and treat chordee bringing the urethra to a more functional location. We incorporated these two principles in GUD. The rationale is to avoid suture urethroplasty, simply repositioning the mobilized urethra distally and working aggressively on glans disassembly creating a more conical and cosmetic glans. The aggressive deconstruction of glans makes this technique unique.

      Conclusion

      We are convinced that this operation can be regarded as a genuine alternative to distal hypospadias after performing 100 cases in 3 years of experience.

      Keywords

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      Linked Article

      • Comment on “The GUD technique: Glandular urethral disassembly for distal hypospadias repair”
        Journal of Pediatric UrologyVol. 16Issue 5
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          I read the article (in press) and watched the video with great interest in the Journal of Pediatric Urology, entitled ‘The GUD technique: Glandular urethral disassembly for distal hypospadias repair’ [1]. The authors describe the mobilization of the urethra, the incision of the glans in the midline and enclose the mobilized urethra in the glans penis. The authors use the definition of “aggressive glans deconstruction” for the urethral and glanular disassembly and propose that its refurbishment creates a much more conical and better cosmesis.
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