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Learn About Conditions and Procedures

What is Trauma?

Trauma is a serious injury or shock to the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors.

It is critical to have an entire team immediately available to provide care to an injured patient 24-hours a day. This teamwork starts at the scene of the injury where a coordinated, statewide pre-hospital medical system rapidly transports the injured patient from the scene to the hospital providing the appropriate level of care according to criteria established in the statewide trauma regulations. Once at the hospital, a complete team of surgeons, emergency physicians and nurses continue the life-saving treatment.

This team approach to care of the injured patient has had a dramatic impact on saving lives.

Minimally Invasive Procedures for Massive Bleeding

Injuries take many forms. The most advanced hospitals can treat injuries with a variety of approaches that involve well-known ones, like surgery, and newer ones where minimally invasive procedures can replace some surgeries.

As a Level 1 Trauma Center, Hartford Hospital has Interventional Radiologists as part of the Trauma Team. They perform procedures such as "embolization" which is a recognized interventional radiology technique that is used to treat trauma patients with massive bleeding.

Click here to see some of the advanced interventional techniques available at Hartford Hospital.

Learn more about trauma, or search below to learn about other health conditions.

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Chordee Repair

Pronounced: kor-DEE ree-pahr

by Deanna M. Neff, MPH

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Chordee repair is a surgery to straighten the penis. It is done to repair a birth defect of the penis called chordee. This defect makes the penis curve downward during an erection.

A chordee repair is done by a specialized doctor called a pediatric urologist. The surgery is typically done after six months of age if the penis curvature is greater than 30 degrees. Curvature of the penis greater than 60 degrees can affect sexual function later in life.

The Male Reproductive System

Reasons for Procedure

This procedure is done on male infants born with:

Chordee
Hypospadias with chordee—the opening of the urethra is on the bottom of the penis instead of at the tip of the penis. Hypospadias can make it difficult for the child to urinate while standing. It can also affect sexual function later in life.

After surgery, the penis should function normally.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If your child is having the surgery, the doctor will review a list of possible complications, which may include:

Shortened penis
Bleeding
Need for another operation
Reaction to the anesthesia (eg, light-headedness, low blood pressure, wheezing)
Infection (wound infection or urinary tract infection)
Psychological trauma

Discuss these risks with the doctor before surgery.

What to Expect

The doctor may do the following:

Physical exam, which may include causing an artificial erection to check the degree of curvature
Blood and urine tests
Discuss the anesthesia being used and the potential risks

Talk to the doctor about your child’s medicines and supplements. Your child may need to stop certain medicines before the surgery. The doctor may also ask that your child take certain medicines to prepare for surgery.

Your child will need to have an empty stomach before the procedure. Ask the doctor when your child will need to stop breastfeeding or eating.

Local or general anesthesia will be used. This will block any pain.

The surgery is usually done in an outpatient setting. Your child will not need to stay in the hospital overnight.

Several techniques may be used to straighten the penis. In general, surgery aims to make the longer and shorter sides of the penis equal in length. Techniques may include:

Releasing tight, shortened foreskin
Suturing extra skin on the longer side with permanent or absorbable stitches
Cutting the lining of the urethra if the urethra is short

An artificial erection will be created using a special injection. This will confirm that the penis is straight. Bandages will be placed around the penis.

About 1-2 hours (longer if your child is having a more complex procedure)

Your child will not feel any pain during surgery. The doctor will give medicine after the procedure to manage pain.

The staff will monitor your child and give him pain medicine as needed.

Swelling of the area is normal. When your child returns home, do the following to help ensure a smooth recovery:

Give medicines as directed. This may include antibiotic ointment to put on the penis.
Your child should only engage in light, gentle activities while the penis is healing.
Keep the bandaged area clean, dry, and protected as directed.
Follow all of the doctor’s instructions.

Call Your Doctor

After arriving home, contact the doctor if any of the following occurs:

Pain that is not controlled with the medicine the doctor has given
Redness, increased swelling, or tenderness in the penis
Bleeding from the penis
Signs of infection, including fever and chills
Nausea or vomiting
Inability to eat or drink
Difficulty urinating or inability to urinate
Catheter or stitches fall out

In case of an emergency, call for medical help right away.

American Academy of Pediatrics

http://www.healthychildren.org/

American Urological Association

http://www.auanet.org/

Canadian Urological Association

http://www.cua.org/

Health Canada

http://www.hc-sc.gc.ca/index-eng.php/

Agency for Healthcare Research and Quality (AHRQ), National Guideline Clearinghouse. Congenital penile curvature. AHRQ, National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=12595&search=chordee. Published March 2009. Accessed September 14, 2012.

Elder J. Anomalies of the Penis and Urethra. In: Kleigman R, Behrman R, Jenson J. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007: chap 544.

Hypospadias. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated October 23, 2011. Accessed September 14, 2012.

Institute for Sexual Medicine. Congenital penile curvature: chordee. Institute for Sexual Medicine website. Available at: http://sexualmed.org/index.cfm/sexual-health-issues/for-men/congenital-penile-curvature-chordee/. Updated March 29, 2010. Accessed September 14, 2012.

Penn State Children’s Hospital. Chordee. Penn State Children’s Hospital website. Available at: http://www.hmc.psu.edu/childrens/healthinfo/c/chordee.htm. Updated October 31, 2006. Accessed September 14, 2012.

Last reviewed September 2012 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.