Preoperative glans & penile dimensions in different hypospadias grades

Abstract

To report glans and penile dimensions in 1023 consecutive boys with hypospadias. Boys admitted for hypospadias surgery between 2016 and 2018 were included in this study. Age ranged between 6 and 36 months. Boys who underwent previous surgery, received hormone therapy or older than 36 months were excluded. The hypospadias was classified according to ICD and WHO classification into glanular (Grade I), distal (Grade II), proximal (Grade III) and perineal (Grade IV). The flaccid penile length (PL), the dorsal glans length (DGL), the ventral glans length (VGL) and the glans width (GW) were measured in the operating room under anaesthesia just before operative correction. Small (GW) in this study was defined as less than 14mm. 1023 boys were included. 273 had glandular, 468 distal, 194 proximal and 88 perineal hypospadias. The mean glans width was 14mm with a range of 8 to 20mm. The mean glans width for glanular hypospadias was 14.0mm (range 9-19mm), 14.0mm (range 10-20mm) for distal hypospadias (p>0.05), 13.1mm (range 9-19mm) for proximal hypospadias (p<0.0001) and 11.1mm (range 8-16mm) for perineal hypospadias (p<0.0001). 460 (45.0%) of all patients presented with a small glans width. In glanular hypospadias it was 99 (36.3%), 167 (35.7%) in distal hypospadias, 111 (57.5%) in proximal hypospadias and 83 (94.3%) in perineal hypospadias. There was no significant difference in the glans size between the age of 6 and 24 months (p>0.2), but there was a difference when compared to patients older than 25 months (p<0.05). A small glans is found in about a third of distal, two thirds in proximal and more than 90% of perineal hypospadias.