Fig. 4

Second-stage of hypospadias repair (same case in Fig. 2, six months later). (a) The penis after correction of chordee in the 1st stage. (b) Thiersch-Duplay urethroplasty; the proximal end of the neourethra is covered by scrotal dartos flap. (c and d) A rectangular area is de-epithelialized along the free edge of the penile skin on one side. (e and f) The de-epithelialized skin flap is fixed to the penile shaft over the neo-urethra to be overlapped by the skin flap from the other side (double breasting skin closure). g) The penile appearance one year later after second stage; note the presence of glanular fistula