Based on the location,
glanular, coronal, subcoronal and midshaft hypospadias were classified as distal, and penoscrotal and perineal ones were classified as proximal hypospadias.
Although classifying hypospadias is not necessarily useful in determining surgical approach, the meatal position can be anterior (distal) that includes
glanular, coronal or subcoronal, mid penile and posterior (proximal) that includes posterior penile, penoscrotal, scrotal or perineal.
Background: Hypospadias is a congenital anomaly in which the meatus opens on the ventral surface of the penis due to the incomplete fusion of urethral folds.1 Hypospadias is the most common congenital malformation of the urethra with affects 1 in 200-300 live male births.2-3 The etiology of hypospadias is speculated to be the fetal exposure to different chemicals with anti-androgen or estrogen like activity, which may interfere with normal hormonal signaling, such as dioxins and furans, polychlorinated biphenyls, organochlorine pesticides, phthalate esters, brominated flame-retardants and some heavy metals.4 Hypospadias is categorized as
glanular, subcoronal, distal penile, proximal penile and penoscrotal.
include chordee, death, destruction (ablation) of the penis,
glanularThe Thiersch Duplay technique (35) and the
glanular approximation procedure (GAP) procedure (36) involve simple tubularization of the UP after lateral incisions circumscribing the meatus.
In group 1, fistula in 4 patients and partial
glanular dehiscence in 1 patient were detected.
concluded that early surgical correction is possible as tunica albuginea plication was also effective in prepubertal period.6,12 The two
glanular hypospadias cases, one is showed in Fig.4, were detected when the foreskin was retracted during circumcision.
(1) It starts as a chronic process, by the formation of infected granulation tissue, which gradually infiltrates the
glanular and cavernous tissues and may invade the whole thickness of the penis.
Hypospadias was
glanular or subcoronal, penile, or perineal in 51 (62.9%), 22 (27.2%), and 8 (9.9%) boys, respectively.
Since the wide urethral plate is always short and adheres to the corporal bodies, causing the ventral clitoral curvature, it is divided at the level of
glanular corona.
By meatal location hypospadias is classified as anterior (
glanular and subcoronal), mid-penile (distal penile, midshaft, and proximal penile), and posterior (penoscrotal, scrotal, and perineal) accounting for 50%, 30%, and 20%, respectively [4].
Patient characteristics Characteristics Number/Mean SD/% Race Malay 53 96.4 Chinese 1 1.8 Siamese z1 1.8 Age At the time of the study 14.89 years (8-23 3.936 years-old) When first seen 9.165 years (1 month-17 4.512 years-old) Type of hypospadias Distal hypospadias 20 36.4
Glanular 1 1.8 Subcoronal 7 12.7 Distal penile 12 21.8 Proximal hypospadias 35 63.6 Proximal penile 12 21.8 Penoscrotal 23 41.8 Previous unsuccessful repair or circumcision before correction Unsuccessful repair 3 5.5 Circumcised 4 7.3 Total associated 10 18.2 anomalies Undescended testis 3 5.4 Retractile testis 1 1.8 Bifid scrotum 2 3.6 Inguinal hernia 3 5.4 Hydrocele 1 1.8 Table 1b.
