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The Glanular-Frenular Collar (GFC) technique: Dual approach to hypospadias reconstruction
1Department of Pediatric Surgery, Division of Pediatric Urology and Andrology, Sechenov First Moscow State Medical University, Moscow, Russia; Tunaboylu Sok. Deniz Apt. No. 17/3, Bakırköy, 34147, İstanbul, Turkey.
Introduction:
The Glanular-Frenular Collar (GFC) technique has evolved since it was first described in 2017. The technique involves reconstruction of the septum glandis, which has been overlooked in the history of hypospadias, and formation of the frenulum, creating the ventral wall of the glanular urethra without dissecting the glans, leaving room for the formation of the navicular fossa.
Material And Methods:
We present a case of distal hypospadias corrected with the GFC technique and demonstrate the important steps of the surgical technique.
Results:
The aesthetic result corresponded to the normal anatomy of the glans and frenular triangle, and the functional result showed a free and wavy shape of urine that resembled the normal flow from the urethra.
Discussion:
In the normal anatomy of the penis, the wings of the glans are separated ventrally by the septum glandis and the frenulum. The navicular-shaped glanular urethra and its vertical, elliptical opening are covered by the fibroelastic septum glandis, unlike the penile urethra, which is surrounded by the corpus spongiosum.
Conclusion:
Reconstruction of hypospadias should include the formation of a septum glandis, frenulum, and navicular fossa. The GFC technique demonstrates the importance of a dual surgical approach for glanular and penile urethra reconstruction.
