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Glans size is an independent risk factor for urethroplasty complications after hypospadias repair
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....
Androgen insensitivity in patients with proximal hypospadias
A number of surgeons use preoperative androgen stimulation for a period of time prior to hypospadias surgery. The aim is to increase glans circumference, penile length and improve prepucial vascularisation pre-surgery. Data confirming the results of these aims is scarce....
TIP hypospadias repair
This paper by one of the current international leaders in hypospadias surgery looks at the outcome of over 1800 consecutive hypospadias repairs using the tubularised incised plate (TIP) repair, beginning from the first original operation through to sequential modifications over...
The GMS hypospadias score
Hypospadias surgery has been carried out for decades. Descriptive parameters for hypospadias severity are variable and difficult to reproduce. The severity of abnormalities lies along a continuous spectrum. The paediatric urological fraternity is attempting to develop more reliable comparators for...
Preoperative use of testosterone prior to distal hypospadias repair
Preoperative hormonal stimulation has been utilised for >50 years in hypospadias surgery. Surgeons utilise testosterone (T) to increase penile size and glans width to try and improve clinical outcomes. However, a paucity of reliable data supporting its use has limited...
Outcomes of preserving the foreskin during distal hypospadias
Hypospadias surgery continues to tax the minds of paediatric urologists. Increasingly distal hypospadias surgery is becoming more and more conservative (in some cases, carrying out only foreskin reconstruction and leaving a mild hypospadias) and the role of foreskin reconstruction as...Paediatric urology – peno-scrotal
Case 1 A four-year-old boy presents to clinic following GP referral unable to retract the foreskin (Figure 1). Figure 1. What is the diagnosis? The above condition may be pathological or physiological; clinically how can you differentiate this? Explain the...Nuptial night tragedy
Case 1 A fit and well 50-year-old gentleman presents to the emergency department with pain and swelling of his penis that started a few hours after he had a shower earlier in the day. On examination, the appearance is as...Balanitis xerotica obliterans
Balanitis xerotica obliterans (BXO) / lichen sclerosus of the male genitalia is a common cause of acquired phimosis, and was first described by Stuhmer in 1928 [1]. It is described in medical literature as a chronic inflammatory condition of unknown...The bulbocavernosus reflex
Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...
Preoperative testosterone for hypospadias
Hypospadias affects around 1 in 400 boys. Glans width (GW) of <14mm has been shown to be an independent risk factor for urethroplasty complications following hypospadias repair. Testosterone (T) administration in prepubertal males increases both penile length and circumference. Its...
