Technical aspects of the Koff procedure (urethral mobilization) in anterior hypospadias

Introduction: In our center the level of division of the corpus spongiosum as the determinant to classifying hypospadias. The hypospadias with a distal division is less severe and they present a little curvature.

Material and methods: We present a case of distal hypospadias corrected by Koff technique and we showed our tricks for avoiding curvature.

Results: In this selected case a Koff procedure are preferred because it has the main advantage of exicing the dysplastic tissues and avoiding a urethroplasty using nonurethral tissues. Late penile curvature is a source of concerns for some, but in our experience no significant curvature was found at follow up.

Discussion: We believe that some tricks, showed in our video, are necessary to avoid iatrogenic curvature and to obtain a good cosmetic result.

Conclusions: Koff technique is a good technique for hypospadias with distal division of corpus spongiosum, without significant curvature at follow up.