Fig. 1

a–c Front and lateral views before stage I repair. Bilateral scrotal separation, severe chordee of the penis, urethra external orifices located at the penile scrotal junction. d The island flap was sutured to form a tube and transposed ventrally. The distal end of the neourethra was sutured with the penile head, and the two wings of the penile head were closed. The proximal end of the formed urethral tube was anastomosed with the urethral plate. e Appearance immediately after stage I repair. Byar’s flaps were created and swung ventrally to cover the ventral defect, and the ventral side of the anastomosis was sutured with the skin around the scrotum to form the stoma. f, g Appearance before stage II repair. The penis was straightened satisfactorily, and the fistula was located at the junction of the penis and scrotum. h The urethral stoma formed in the first stage was dissociated, and the urethra was sutured. i Ventrally transposed thick and healthy dartos tissue near the fistula was used to cover the neourethra. j State during urination 3 months after stage II repair. The patient achieved an apical slit-like meatus at the tip of the glans penis, a single forward stream, unimpeded voiding, and good cosmesis