Coronal Hypospadias: An Assessment of Surgical Treatment Outcomes

A urethral meatus located in the region of the coronal sulcus accounts for approximately 25% of all hypospadias cases. Numerous surgical methods exist for the correction of this penile anomaly. According to the literature, the complication rate for this treatment ranges from 2% to 25%.

The aim of this study is to assess the outcomes of coronal hypospadias treatment in boys operated on using a surgical method developed at the Department of Paediatric and Adolescent Surgery, Institute of Mother and Child.

Between 2005 and 2023, 265 boys, aged 14 to 20 months, underwent surgery for coronal hypospadias. The operative technique involves a longitudinal incision of the dorsal part of the urethral meatus, parallel incisions of the glans, and the placement of a mattress suture encompassing the glans and the urethral apex bilaterally in the midline. Subsequently, any ventral penile curvature is corrected, and the frenulum, the normal shape of the prepuce (foreskin), and the penile skin are reconstructed. In all operated boys, a follow-up assessment was conducted at least one-year post-surgery, evaluating the location of the external urethral meatus, penile curvature, the appearance of the prepuce and penile skin, and the presence of any urethrocutaneous fistulas.

Of the 265 operated boys, a correctly positioned external urethral meatus was observed in 254. No patient was found to have penile curvature. The shape of the prepuce and skin was deemed normal in 256 patients. Re-reconstruction of the urethra was required in 8 patients due to meatal retraction and in 3 patients due to a fistula. The postoperative observation period was a minimum of one year.

Based on the results of this study and a comparison with literature data, it can be concluded that the surgical method for treating coronal hypospadias developed at the Department of Surgery, Institute of Mother and Child, yields good functional results and a satisfactory cosmetic appearance of the penis.