In this analysis, prepubertal patients undergoing hypospadias repair over a four-year period had caliper measurement of glans width taken perioperatively. Multivariate logistic regression analysis was carried out for complications while adjusting for patient age, meatus position or type of repair. A small glans was defined as less or equal to 14mm. Four hundred and ninety boys had a mean glans size of 15mm (10-27). Primary operations were undertaken in 432 and 58 patients had ‘re-do’ surgery for repairs. Interestingly, increasing age between three months and 10 years did not correlate with changing glans size. The glans was small (<14mm) in 17%. Complications of surgery occurred in 25% of patients with small glans vs. 10% of those with larger glans (p=0.0003). Multivariate analysis showed that small glans size, re-operations and mid / proximal meatus position were independent risk factors for urethroplasty complications. The study authors suggest that measurement of glans size perioperatively may allow for modification of technique such as changing for a single stage to a two-stage repair. 

Glans size is an independent risk factor for urethroplasty complications after hypospadias repair.
Bush N, Villanueva C, Snodgrass W.
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Henrik Steinbrecher

Southampton University Hospital NHS Trust

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