Normal anatomy of the external urethral meatus in boys: implications for hypospadias repair

Abstract

Both papers in this section relate to the always difficult subject of hypospadias repair. One of them describes the anatomy of the external urethral meatus, and the other a technique for repairing coronal or subcoronal hypospadias. To investigate the normal external urethral meatal anatomy in boys, and to examine the proportional relationship between meatal length and degree of ventral glans closure. In all, 92 boys with presumed normal penile anatomy were considered eligible for the study; 17 were not assessed because either the boy or parents declined to participate, leaving 75 boys (mean age 6.9 years, range 0.3-15) who completed the study. Photographic records of the meatal appearance were obtained and meatal height and ventral glans closure measured using ophthalmic callipers. All 75 boys in the study had a vertical slit-like meatus that commenced at the tip of the penis and ran ventrally. The mean (sd) vertical meatal length was 5.4 (1) mm and the mean length of ventral glans closure was 4.7 (1.2) mm. There was an age-dependent increase in meatal length and a similar association was identified for the length of ventral glans closure. There was also a statistically significant proportional relationship between meatal length and length of glans closure (r = 0.36, confidence interval 0.14-0.54, P < 0.002). The position and size of the external urethral meatus in normal boys is consistent, and ventral glans closure is equal to or slightly less than meatal length. These data might be of interest to hypospadiologists in their efforts to reconstruct normal glanular anatomy.