New method of glanuloplasty in patients with hypospadias

The anatomy on the distal part of urethra and penis glans also methods of the glanuloplasty are not described in details for hypospadias and epispadias repair. We sought to specifically address this problem We proposed the modified glanuloplasty with short superficial glans wing connection (GSSGWC) considering our anatomic findings. A total of 410 patients aged 1 to 18 years with hypospadias were operated by single surgeon. Of those, 21,4% with hypospadias had history of a previous failed hypospadias repair attempt. Distal and coronal hypospadias was seen in 69 patient and MAGPI procedure was done in these cases. In 243 cases penile hypospadias was corrected with TIP urethroplasty (n=123), grafted TIP (n=25), onlay urethroplasty (n=23), flip-flap urethroplasty (Mathieu procedure) (n=72). In cases of scrotal and perineal hypospadias (n=98) urethroplasty was performed with tubulirized transverse prepuce flap. We found out the glans spongiosum tissue surrounds the urethra not circularly. The urethra is displaced ventrally and glans wings are connected to each other by the glans frenulum. The spongiosum tissue doesn’t stretch but the frenulum is stretched quite well during the micturition. We described our experience of modified glanuloplasty with mobilization. Of the 420 patients the long-term results were recorded in 385 children. The modified glanuloplasty alowed to decrease the number of the distal urethra stenosis three times and to decrease fistula formation rate from 19.5% to 11.4%. Also in 8-12 months maximum and average flow were above the fifth percentile in 92,8% in the first group and 83% in the second group respectively. The modified glanuloplasty provides more physiological glans wings connection that’s proved be uroflow data.