Digital photographic measurement in hypospadias: validation and comparison to intraoperative measurement

J Pediatr Urol. 2014 Apr;10(2):312-6. doi: 10.1016/j.jpurol.2013.10.012. Epub 2013 Nov 7.


Background: We propose a standardized method of photographing the hypospadias penis to capture penile dimensions that may be relevant for surgery. We also validate the use of digital imaging software for calculating penile dimensions as a substitute for intraoperative caliper-based measurements.

Methods: Photographs were taken of hypospadias penises in four different views after placement of a traction stitch and retraction of the preputial hood. Intraoperative measurements were obtained with a caliper. Digital measurements were taken of the same parameters postoperatively. All measurements were obtained in triplicate by multiple participants, and averages were tested for equivalency by determining the correlation coefficient for each parameter. Inter-observer correlation was also calculated for each parameter.

Results: 180 intraoperative and 180 digital measurements were taken from 60 dimensions on 10 hypospadiac penises. Strong correlation existed between most digital and intraoperative measurements. Average inter-observer correlations ranged from 0.91 to 0.99 for each of the intraoperative measurements, and 0.90 to 1.00 for each of the digital measurements.

Conclusions: Standardized imaging is effective in capturing penile dimensions and measurements during hypospadias surgery. When compared with intraoperative measurements, digital measurements are reliable and precise; digital photography has the potential to both aid in surgical planning and improve documentation.

Keywords: Digital measurements; Hypospadias; Photography; Standardization.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Child, Preschool
  • Cohort Studies
  • Follow-Up Studies
  • Hospitals, Pediatric
  • Humans
  • Hypospadias / diagnosis*
  • Hypospadias / surgery*
  • Image Processing, Computer-Assisted* / methods
  • Infant
  • Intraoperative Care / methods*
  • Male
  • Photography / methods*
  • Preoperative Care / methods
  • Sensitivity and Specificity
  • Treatment Outcome
  • Urethra / surgery*
  • Urologic Surgical Procedures, Male / methods
  • Weights and Measures