A 6-month-old boy has distal hypospadias with a meatus at the coronal level and mild ventral curvature. The surgeon plans tubularised incised plate (Snodgrass) repair. Which manoeuvre must be avoided as part of this repair?
- A Circumcision with discard of the preputial skin ✓
- B Meatoplasty and glansplasty
- C Correction of chordee
- D Use of a dorsal plication stitch
Correct answer: A. Circumcision with discard of the preputial skin
Explanation
The hooded dorsal foreskin is vascularised tissue that is routinely used as flaps or grafts for neourethral coverage in hypospadias repair, so circumcision with removal of the foreskin compromises the repair. Chordee correction, glansplasty and dorsal plication for mild curvature are all legitimate components of reconstruction. This is a classic exam point: the child with hypospadias should not be circumcised before repair because the prepuce is spare tissue for the operation.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.