Is glans penis width a risk factor for complications after hypospadias repair?

Faasse, Mark A.; Johnson, Emilie K.; Bowen, Diana K.; Lindgren, Bruce W.; Maizels, Max; Marcus, C.R.; Jovanovic, Borko; Yerkes, Elizabeth B.

doi:10.1016/j.jpurol.2016.04.017

Cited by 29 publications

(14 citation statements)

References 14 publications

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“…Penis size can be evaluated by glans width and, obviously, increases with age. The mean glans width of 13.9 mm in the present study was smaller than that of 15 mm reported by Bush and Faasse, although the mean age was greater than theirs . Therefore, penis size can vary across geographic regions or ethnicities in addition to age.…”

Section: Discussioncontrasting

confidence: 79%

“…The mean glans width of 13.9 mm in the present study was smaller than that of 15 mm reported by Bush and Faasse, although the mean age was greater than theirs. 12,14 Therefore, penis size can vary across geographic regions or ethnicities in addition to age. The mean urethral plate width of 5.3 mm in the present study, similar to 6 mm reported by Snodgrass, 15 was remarkably smaller than that of 8 mm reported by Sarhan.…”

Section: Discussionmentioning

confidence: 99%

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Width proportion of the urethral plate to the glans can serve as an appraisal index of the urethral plate in hypospadias repair

Shen²,

Tang

et al. 2018

Int J of Urology

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Width proportion of the urethral plate to the glans can serve as an appraisal index of the urethral plate in hypospadias repair

Shen²,

Tang

et al. 2018

Int J of Urology

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“…Although smaller glans widths are thought to be associated with greater difficulty and perhaps complications, our study along with some other studies, hasn't shown glans diameter to be a risk factor for complications after TIP [26][27][28][29]. Also we found no significant differences in glanular groove shapes ( complete cleft, incomplete cleft, flat ) between two groups.…”

Section: Glanscontrasting

confidence: 64%

“…Other studies have failed to find any significant connection between UP width and complications [25][26][27].…”

Section: Discussionmentioning

confidence: 91%

A Prospective Study of Outcomes After Tubularized Incised Plate (TIP) Urethroplasty: a Multivariable Analysis of Prognostic Factors in Children 1-3 Years Old

Roshandel

Rashed

Badr

et al. 2020

Preprint

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Background: Tubularized incised plate (TIP) urethroplasty as the most common hypospadias repair method, aims to achieve normal functioning of the penis along with cosmetic reconstruction. However, there are remaining questions toward anatomical prognostic factors affecting the results of surgery. Lack of age-matched controls or controlling for meatal location, employment of several surgical techniques or multiple surgeons, or age heterogeneity of the study population are the problems affected the results of the current body of literature. Objective: This prospective study aimed to evaluate the preoperative factors to predict future complications associated with hypospadias repair outcomes in males aged between 1-3 years and performed by a single surgeon with employing multivariate analysis. Patients and methods: A prospective cohort of 101 males aging from 1 to 3 years with distal to mid-shaft hypospadias were consecutively selected for TIP repair. The urethral plate dimensions in erect and flaccid states, penile length, glans diameter, and chordee were evaluated individually before reconstruction. After surgery and during follow-up visits, the subsequent transient and persistent complications were recorded. Results: Postoperatively, the acute transient events were observed in 42 cases (41.6%) and the persistent complications in 16 cases (15.8%). The uncomplicated group had a higher percentage of patients with distal meatal location than the complicated group (P=0.01%). Furthermore, fistula formation was notably higher in the group with acute surgical site infection (P<0.001). The analysis also showed the width of the urethral plate to be inversely associated with the development of complications (P=0.03). Conclusion: By performing TIP by a single surgeon on a homogenous study population and eliminating the impact of severe chordee as a potential cofounding variable, this study prospectively found that out of the anatomical specifications, pre- and postoperative factors, the urethral meatus location was the only significant and independent predictor of the development of complications in young children with midshaft to distal hypospadias. Finally based on the inverse association of width with the complications we hypostatized that a combination of urethral width and depth should be considered in the investigation of prognostic factors for hypospadias repair outcomes.

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“…Supplemental testosterone increases glans width prior to surgery, potentially reducing this risk 35 – 37 . Although a recent report disputed the significance of glans size and risk of complication 38 , 39 , smaller glans size presents a challenge in the operating room. Preoperative testosterone use should be studied in a randomized, prospective study to determine its role in surgical outcomes, as its exact benefit remains to be elucidated in a satisfactory fashion 40 .…”

Section: Factors Contributing To a High Complication Ratementioning

confidence: 99%

Proximal hypospadias: we aren’t always keeping our promises

Long

Canning

2016

F1000Res

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Hypospadias surgery is a humbling art form. The evolution of surgical techniques has made distal hypospadias outcomes favorable, but recent publications suggest that our complication rates for proximal hypospadias are much higher than previously reported. To explain these shortcomings, we examine the literature and focus on the lack of standardized documentation, the subsequent inability to objectify the severity of the phenotype, and the underestimation of complications due to lack of long-term follow up. The variability in surgical technique and the fact that the literature abounds with small case series from single institutions also limits our ability to compare outcomes. We believe that the use of standardized and scored phenotype assessments from diagnosis through the extended postoperative period will allow for improved scientific assessment of outcomes. This will facilitate multi-institution collaboration and tabulation of outcomes, allowing rapid data accumulation and assessment for this rare disorder. As surgeons, we must follow boys through puberty into adulthood and must honestly report our results in order to advance our surgical approach to this complicated problem.

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Is glans penis width a risk factor for complications after hypospadias repair?

Cited by 29 publications

References 14 publications

Width proportion of the urethral plate to the glans can serve as an appraisal index of the urethral plate in hypospadias repair

Width proportion of the urethral plate to the glans can serve as an appraisal index of the urethral plate in hypospadias repair

A Prospective Study of Outcomes After Tubularized Incised Plate (TIP) Urethroplasty: a Multivariable Analysis of Prognostic Factors in Children 1-3 Years Old

Proximal hypospadias: we aren’t always keeping our promises

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