Chordee | Definition, Surgery, And Repair

Chordee is a medical condition that affects the cosmetic appearance of penis. It is characterized by formation of thick fibrous tissue bands that pulls the penis sideward; thereby making it look curvy or bent. It is noteworthy that the curviness of penis becomes particularly prominent during penile erection.

This condition is frequently observed in young males who have hypospadias.

What Is Hypospadias And How Can It Lead To Chordee?

Hypospadias is a congenital (by birth) structural deformity of penis that is marked by presence of urinary duct on the underside of penis instead of tip (like in normal cases). In most cases, the displacement is only mild, but in some rare cases, the displacement may extend as far as the testicles. Here are some important facts that you must know about Chordee:

• In most cases, hypospadias co-exists with chordee
• Chordee rarely exists as a sole defect
• The condition is usually identifiable soon after the birth
• There are no known causes, but certain risk factors can aggravate the risk of developing chordee; for example, irregular growth under the tip of penis may lead to a shift in the penile curvature.
• Other congenital deformities such as small urethra can also lead too chordee.
• If penis has a hooded appearance due to presence of extra foreskin, parents should speak to a healthcare professional as this is a suggestive sign of co-existing chordee
• The condition should ideally be treated in the young age (within 6-18 months after birth) to minimize the risk of long term complications

What To Do If You Have Chordee?

Besides affecting the urinary stream (especially while urinating in the standing posture), this condition can also lead to varying degree of sexual dysfunction. That’s why healthcare providers strongly recommend treating this condition as soon as possible. Ideally, surgical intervention is recommended to remove thefibrous tissue as well as correct the hypospadias.

Fortunately, most cases are diagnosed soon after birth, but a few cases may first come to notice in the adolescence. Although, surgery can be a little complicated if the procedure is performed at an older age, but nevertheless, symptoms can be resolved without any residual complications.

Chordee Repair

The repair procedure is usually performed by a pediatric urologist and may take about 1-3 hours. After the surgery, patient can be sent home the same day. The type of surgery is determined by the extent of curvature defect and other congenital abnormalities.

The risk of complications is rare if procedure is performed under aseptic measures. Here are some complications that may occur in some patients:

• Infection
• Need for an additional surgery
• Scarring
• Infection of wounds
• Allergic response to anesthetic agent

In order to optimize the healing process, make sure to keep the surgical area clean and dry. Ideally, the baby should not be bathe for the first 7 days. The baby should also be fed liquid diet.

When To See A Doctor?

Follow up with your doctor if you are experiencing following symptoms:

• Signs of infection (such as chills, rigors, nausea, vomiting, fever etc.)
• Difficulty in passing urine
• Discharge of blood from the penis
• Inflammation or falling out of stitches
• Excessive pain that doesn’t relieve from pain-killers

References

• Zheng, D. C., Yao, H. J., Cai, Z. K., Da, J., Chen, Q., Chen, Y. B., ... & Wang, Z. (2015). Two-stage urethroplasty is a better choice for proximal hypospadias with severe chordee after urethral plate transection: a single-center experience. Asian journal of andrology, 17(1), 94.
• Chen, C., Yang, T. Q., Chen, J. B., Sun, N., & Zhang, W. P. (2016). The effect of staged transverse preputial island flap urethroplasty for proximal hypospadias with severe chordee. The Journal of urology, 196(5), 1536-1540.