The Modified Asopa (Hodgson XX) Procedure to Repair Hypospadias with Chordee

  • Jeffrey Wacksman


Midpenile and proximal penile hypospadias is usually associated with chordee that causes a ventral deflection of the penile shaft. The chordee may be superficial (skin and/or dartos tissue) or deep (dysplastic urethral remnants and corpus spongiosum). With cases of superficial chordee, this is usually corrected by dividing the skin and dartos tissue. In many cases, the urethral plate can be tubularized via the TIP procedure and/or onlay graft placed to repair this defect. When the chordee is more extreme, then the urethra itself will need to be constructed utilizing some type of skin, usually from the prepuce. In 1971, Asopa et al. reported on a transverse pedicle flap utilizing the underneath surface of the prepuce to replace the urethra. The major problem with this technique was penile torsion due to the transference of the entire preputial skin with the attached skin tube.


Urethral Stricture Urethral Diverticulum Proximal Urethra Urethral Plate Corpus Spongiosum 
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  1. Asopa HS, Elhence EP, Atria SP, et al: One-stage correction of penile hypospadias using a foreskin tube. Int Surg. 1971; 55:435.PubMedGoogle Scholar
  2. Duckett JW: The island flap technique for hypospadias repair. Urol Clin North Am. 1981; 8:503.PubMedGoogle Scholar
  3. Wacksman J: Use of the Hodgson XX (modified Asopa) procedure to correct hypospadias with chordee: surgical technique and results. J Urol. 1986; 136:1264.PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2004

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  • Jeffrey Wacksman

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