Abstract
Introduction: Comparison of penile measurements between boys with and without hypospadias is important to determine whether there is any truth in the notion that the hypospadic penis is shorter than its age-matched normal counterpart. This study was designed to check whether there was any difference in penile sizes between Nepalese boys with and without hypospadias.
 Methods: A cross-sectional study was conducted among 72 Nepalese boys (36 with hypospadias and 36 without hypospadias) attending the paediatric surgical unit of Kathmandu Medical College Teaching Hospital between July 2019 and June 2020. The penile length was measured in both the flaccid state and the stretched state yielding the flaccid penile length (FPL) and the stretched penile length (SPL) for each subject utilizing standardized measuring conditions. The SPL/FPL ratio was calculated for each patient.
 Results: The mean FPL in the hypospadias group (A) was 3.42±0.80cms while that in the normal group (B) was 3.62±0.61cms. The mean SPL in group A was 4.58±0.94cms compared to 5.52±0.68cms in group B. The SPL/FPL ratio was 1.34±0.14 in group A compared to 1.54±0.17 in group B. The difference in FPL was not significant between groups but the difference in SPL and the SPL/FPL ratio was statistically significant between groups.
 Conclusion: The flaccid penile length (FPL) does not vary between the two groups. However, the stretched penile length (SPL) and the Stretched penile to Flaccid penile length ratio (SPL/FPL ratio) are significantly different between the two groups of boys.
Highlights
Comparison of penile measurements between boys with and without hypospadias is important to determine whether there is any truth in the notion that the hypospadic penis is shorter than its DJHPDWFKHG QRUPDO FRXQWHUSDUW 7KLV VWXG\ ZDV GHVLJQHG WR FKHFN ZKHWKHU WKHUH ZDV DQ\ GL൵HUHQFH LQ penile sizes between Nepalese boys with and without hypospadias
This is in sharp contrast WR WKH ¿QGLQJV RI 7HFNFKDQGDQL DQG %DMSDL5 who found that none of their patients with distal and mid-penile hypospadias had chordee while all with proximal hypospadias had chordee (34%)
The higher proportion of boys with chordee in our study may explain VRPH RI WKH GL൵HUHQFHV LQ RXU ¿QGLQJV SDUWLFXODUO\ WKH ¿QGLQJV RI 63/ DQG WKH 63/)3/ UDWLR :H KRZHYHU did not compare between boys with and without chordee due to the very small proportion of boys without chordee, which would make comparison unfavorable and skewed
Summary
Comparison of penile measurements between boys with and without hypospadias is important to determine whether there is any truth in the notion that the hypospadic penis is shorter than its DJHPDWFKHG QRUPDO FRXQWHUSDUW 7KLV VWXG\ ZDV GHVLJQHG WR FKHFN ZKHWKHU WKHUH ZDV DQ\ GL൵HUHQFH LQ penile sizes between Nepalese boys with and without hypospadias. Penile length is an important criterion for patient satisfaction after hypospadias surgery.[1,2,3] because of apparent ventral hypoplasia of the hypospadic penis, it has long been thought that these penises were shorter when compared to their normal counterparts. This seems more of DORJLFDOVSHFXODWLRQUDWKHUWKDQDQH[SHULPHQWDO¿QGLQJDV evidenced by the fact that there have been only a few studies comparing the penile lengths between these two populations.[4,5] it is imperative to experimentally verify whether there is any truth in that notion. The handful of publications comparing the preoperative GL൵HUHQFHVLQSHQLOHOHQJWKVEHWZHHQWKHVHWZRSRSXODWLRQV KDYH PHDVXUHG HLWKHU WKH ÀDFFLG SHQLOH OHQJWK4 or the stretched penile length[5], and have concluded that there was QR GL൵HUHQFH LQ SHQLOH OHQJWK EHWZHHQ WKHVH WZR JURXSV RI ER\V %RWK RI WKHVH WZR VWXGLHV ZHUH GRQH LQ GL൵HUHQW SRSXODWLRQVZLWKGL൵HUHQWUDFLDOHQYLURQPHQWDODQGVRFLR FXOWXUDO SUR¿OHV:H NQRZ WKDW WKH DYHUDJH SHQLOH OHQJWK varies widely between populations as can be evidenced by WKHGL൵HUHQWQRPRJUDPVRISHQLOHOHQJWKVRIQRUPDOER\V LQGL൵HUHQWFRXQWULHV6-11 Such nomograms are not available for Nepalese boys.
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