Complication and outcome of dorsal plication versus ventral lengthening in hypospadia with chordee

Purpose: This review compared outcomes and complications of dorsal plication (DP) and ventral lengthening (VL). Materials and methods: We included English-language studies (2000–2023) reporting outcomes of DP or VL in hypospadias with chordee. Eligible designs were cohort, retrospective, and case reports with extractable complication or outcome data. Searches were performed in PubMed/MEDLINE, Cochrane Library, Web of Science, and Google Scholar using the terms DP, VL, hypospadias, chordee/penile curvature, and complication/outcome/success rate with the last update in December 2023. Two reviewers independently assessed risk of bias using the Newcastle–Ottawa Scale. Due to heterogeneity, results were synthesized narratively and tabulated. Results: Seven studies involving 537 patients were included. VL demonstrated lower recurrence of ventral curvature (9.4%) compared with DP (27.9%), with success rates up to 97.7%. Both techniques were associated with complications including fistula, diverticulum, stricture, and dehiscence, though recurrence was more frequent after DP. Study quality was limited by small sample sizes, retrospective designs, and inconsistent reporting of functional outcomes. Conclusion: VL may offer advantages in terms of lower recurrence rates and fewer complications compared with DP; however, high-quality prospective studies with standardized outcome reporting and long-term follow-up are required to confirm these findings.