Glans meatus proportion in hypospadias versus normal: does marking reference points impact outcome?

Abstract

Objective: The aims of this study were to assess anatomical landmarks with reference to urethral meatus and glans in hypospadias and compare the findings with those of healthy individuals, and to assess whether marking reference points helps in improving outcome.

Methods: 1. Patients who underwent repair for hypospadias had reference points marked. Vertical meatal length, ventral glans closure and glans meatus proportion were derived, and the values compared with those obtained from healthy boys. 2. The outcomes of TIP repair after marking reference points (Group I) were compared with those of a similar group without skin markings (Group II).

Results: 1. There was significant difference in the age distribution of hypospadiac patients and healthy individuals, reflected in the meatal length and ventral glans closure. However, there was no significant difference in glans meatus proportion. 2. The fistula rate was 2/35 (5.7%) in group I compared with 5/47 (10.5%) in group II. The meatal stenosis was 2/35 (5.7%) in group I and 4/47 (8.5%) in group II.

Conclusion: 1. Anatomical landmarks in hypospadias are similar to those found in healthy individuals. 2. Marking reference points prior to incision helps to reduce the rate of meatal stenosis and fistula.

Keywords: Anatomy; Glans meatus proportion; Hypospadias; Outcome; Ventral glans closure.