Definition
Definition
Chordee repair is a surgery to straighten the penis. It is done to repair a birth defect of the penis called chordee. This defect causes the penis to be curved, which is most obvious during an erection.
A chordee repair is done by a specialized doctor called a pediatric urologist. The surgery is typically done after 6 months of age.
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Reasons for Procedure
Reasons for Procedure
This procedure is done on boys born with:
- Chordee
- Hypospadias with chordee—the opening of the urethra is on the bottom of the penis instead of at the tip of the penis. Hypospadias can make it difficult for the child to urinate while standing. It can also affect sexual function later in life.
After surgery, the penis should function normally.
Possible Complications
Possible Complications
Complications are rare, but no procedure is completely free of risk. If your child is having the surgery, the doctor will review a list of possible complications, which may include:
- Shortened penis
- Bleeding
- Need for another operation
- Reaction to the anesthesia
- Infection
- Psychological trauma
Discuss these risks with the doctor before surgery.
What to Expect
What to Expect
Prior to Procedure
The following may be done:
- Physical exam, which may include causing an artificial erection to check the degree of curvature
- Blood and urine tests
- A discussion about the anesthesia being used and the potential risks
Talk to the doctor about your child’s medications and supplements. Your child may need to stop certain medications before the surgery. Your child may also need to take certain medications to prepare for surgery.
Your child will need to have an empty stomach before the procedure. Ask the doctor when your child will need to stop breastfeeding or eating.
Anesthesia
Local or general anesthesia will be used. This will block any pain.
Description of Procedure
Several techniques may be used to straighten the penis. In general, surgery aims to make the longer and shorter sides of the penis equal in length. Techniques may include:
- Removing tissue that is constricting the erection
- Making the longer and shorter sides of the penis equal in length
- Lengthening the urethra if the urethra is short—tissue from the foreskin or another site will be used
An artificial erection will be created using a special injection. This will confirm that the penis is straight. Bandages will be placed around the penis.
How Long Will It Take?
About 1-2 hours—longer if your child is having a more complex procedure
The surgery is usually done in an outpatient setting. Your child will not need to stay in the hospital overnight.
How Much Will It Hurt?
Your child will not feel any pain during surgery. Medication will be given after the procedure to manage pain.
Post-procedure Care
At the Care Center
The staff will monitor your child and give him pain medication as needed.
During your stay, the hospital staff will take steps to reduce your child’s chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your child’s incisions covered
There are also steps you can take to reduce your child’s chances of infection such as:
- Washing your hands and your child’s hands often and reminding visitors and healthcare providers to do the same
- Reminding your child’s healthcare providers to wear gloves or masks
- Not allowing others to touch your child’s incisions
At Home
When your child returns home, do the following to help ensure a smooth recovery:
- Your child should only engage in light, gentle activities while the penis is healing.
- Follow all of the doctor’s instructions.
Call Your Doctor
Call Your Doctor
After arriving home, contact the doctor if any of the following occurs:
- Pain that is not controlled with the medication that has been given
- Redness, increased swelling, or tenderness in the penis
- Bleeding from the penis
- Signs of infection, including fever and chills
- Nausea or vomiting
- Inability to eat or drink
- Difficulty urinating or inability to urinate
- Stitches fall out
In case of an emergency, call for emergency medical services right away.
RESOURCES:
Healthy Children—American Academy of Pediatrics http://www.healthychildren.org
CANADIAN RESOURCES:
References:
http://www.guideline.gov/content.aspx?id=37628&search=congenital+penile+curvature
Published February 2012. Accessed September 11, 2014.
Congenital penile curvature: chordee. Institute for Sexual Medicine website. Available at:
http://sexualmed.org/index.cfm/sexual-health-issues/for-men/congenital-penile-curvature-chordee/
Accessed September 11, 2014.
Hypospadias. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated March 26, 2015. Accessed May 6, 2015.
Hypospadias/chordee. Cincinnati Children’s Hospital website. Available at:
http://www.cincinnatichildrens.org/health/h/hypospadias
Updated June 2013. Accessed May 6, 2015.
Mingin G, Baskin L. Management of chordee in children and young adults. Urol Clin N Am. 2002;29:277-284.
Montag S, Palmer L. Abnormalities of penile curvature: chordee and penile torsion. ScientificWorldJournal. 2011 Jul 28;11:1470.
Snodgrass W. Management of penile curvature in children. Curr Opin Urol. 2008;18:431-435.
Penile chordee. North Texas Pediatric Urology Associates website. Available at:
http://www.urologyclinics.com/assets/images/NTPUAChordeePhalloplasty.pdf
Accessed May 5, 2015.
Last Updated: 5/13/2015