Treatment of hypospadias by a modified Cloutier two-stage repair

After a tentative beginning, the two-stage hypospadias repair described by Cloutier was progressively modified and in our hands proved applicable to a wide range of hypospadias. Results improved with experience. The modified procedure has a low complication rate and has given a normal appearing circumcised penis with a spiral urinary stream through a vertically oriented glandular meatus (Fig 5), and erections are normal. Because of the long-term importance to the patient, the normal appearance is emphasized.