Diagnostic oversight in adult dorsal chordee with occult epispadiac urethral fistula likely secondary to childhood urethroplasty – a case report

Dorsal chordee is a rare congenital penile curvature, typically diagnosed in childhood. Occult urethral anomalies in adults are uncommon and may remain undetected due to subtle presentation and incomplete medical history. We report a 22-year-old male presenting with dorsal penile curvature. Preoperative clinical evaluation and cystoscopy were normal. During corrective surgery, an incidental epispadiac urethral fistula was identified following leakage of lignocaine jelly after catheterization. A three-layer turn-over flap repair using preputial tissue was performed along with chordee correction. The postoperative course was uneventful, with excellent functional and cosmetic outcomes. The fistula was initially presumed congenital; however, operative findings and prior surgical history suggested a likely postoperative etiology following childhood distal epispadias repair. This case highlights the limitations of routine preoperative assessment and emphasizes the importance of intraoperative vigilance in detecting concealed urethral anomalies.