Hypospadia and Urethral Stricture

  • Carlos Arturo Levi D’Ancona
  • Juliano Cesar Moro
  • Caio Cesar Citatini de Campos
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)


The aim of this chapter is to provide the reader a brief panorama of hypospadias embryology and diagnosis, besides providing long-term follow-up data based on different aspects. Patients’ satisfaction from childhood to adulthood, regarding cosmetic and sexual status, as well as the use of urodynamics and uroflowmetry in hypospadias evaluation will be stated. Patient medical care must go beyond the repositioning of the urethral meatus. Several more evident functional aspects such as penis size and aspect of the glands can cause psychological damage related to self-image, leading to sexual disorders.

In addition, unusual functional aspects of the lower urinary tract, less explored in clinical practice, should be considered. Urine flow, detrusor activity, and urethral stricture should also be evaluated for their potential to cause urinary symptoms in these patients. Long-term outcomes provided in this chapter will take the reader to an up-to-date panel of hypospadias.


Hypospadias Ventral curvature Urethra Self-image Urine flow Cosmetic Urodynamics Detrusor overactivity Urethral stricture Sexuality 


  1. 1.
    McDougal SW, Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, Ramchandani P. Campbell-Walsh urology. 10th ed. Philadelphia: Saunders Elsevier; 2012.Google Scholar
  2. 2.
    dos Reis RB, Zequi SC, Filho MZ. Urologia moderna. 1a ed. São Paulo: Lemar; 2013.Google Scholar
  3. 3.
    Kurahashi N, Murakumo M, Kakizaki H, et al. The estimated prevalence of hypospadias in Hokkaido, Japan. J Epidemiol. 2004;14:73–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Canon S, Mosley B, Chipollini J, et al. Epidemiological assessment of hypospadias by degree of severity. J Urol. 2012;188:2362–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Kalfa N, Sultan C, Baskin LS. Hypospadias: etiology and current research. Urol Clin North Am. 2010;37(2):159–66.CrossRefPubMedGoogle Scholar
  6. 6.
    Macedo A Jr, Rondon A, Ortiz A. Hypospadias. Curr Opin Urol. 2012;22(6):447–52.CrossRefPubMedGoogle Scholar
  7. 7.
    Baskin LS. Hipospadias. In: Antono Macedo Jr., Salvador Vilar Correia Lima, Descio Streit, Ubirajara Barroso Jr., editors. Urologia Pediátrica. 1a ed. São Paulo: Roca; 2004. p. 193–194.Google Scholar
  8. 8.
    Baskin LS, Ebbers MB. Hypospadias: anatomy, etiology, and technique. J Pediatr Surg. 2006;41:463–72.CrossRefPubMedGoogle Scholar
  9. 9.
    Weber DM, Schonbucher VB, Landolt MA, Gobet R. The pediatric penile perception score. An instrument for patient self-assessment and surgeon evaluation after hypospadias repair. J Urol. 2008;180:1080–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Rynja SP, De Jong TPVM, Bosch JLHR, De Kort LMO. Functional, cosmetic and psychosexual results in adult men who underwent hypospadias correction in childhood. J Pediatr Urol. 2011;7:504–15.CrossRefPubMedGoogle Scholar
  11. 11.
    Kumar MV, Harris DL. A long term review of hypospadias repaired by split preputial flap technique. Br J Plast Surg. 1994;47:236–40.CrossRefPubMedGoogle Scholar
  12. 12.
    Aho MO, Tammela OK, Somppi EM, Tammela TL. Sexual and social life of men operated in childhood for hypospadias and phimosis. A comparative study. Eur Urol. 2000;37(1):95–100.CrossRefPubMedGoogle Scholar
  13. 13.
    Kiss A, Sulya B, Szasz AM, Romics I, Kelemen Z, Tóth J, et al. Long-term psychological and sexual outcomes of severe penile hypospadias repair. J Sex Med. 2011;8:1529–39.CrossRefPubMedGoogle Scholar
  14. 14.
    Aulagne MB, Harper L, de Napoli-Cocci S, Bondonny JM, Dobremez E. Long-term outcome of severe hypospadias. J Pediatr Urol. 2010;6(5):469–72.CrossRefPubMedGoogle Scholar
  15. 15.
    Hoag CC, Gotto GT, Morrison KB, Coleman GU, Macneily AE. Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood. Can Urol Assoc J. 2012;2(1):23–31.CrossRefGoogle Scholar
  16. 16.
    Lam PN, Greenfield SP, Williot P. 2-stage repair in infancy for severe hypospadias with chordee: long-term results after puberty. J Urol. 2005;174(4 Pt 2):1567–72.CrossRefPubMedGoogle Scholar
  17. 17.
    Ruppen-Greeff NK, Weber DM, Gobet R, Landolt MA. What is a good looking penis? How women rate the penile appearance of men with surgically corrected hypospadias. J Sex Med. 2015;12(8):1737–45.CrossRefPubMedGoogle Scholar
  18. 18.
    Örtqvist L, Fossum M, Andersson M, Nordenström A, Frisén L, Holmdahl G, Nordenskjöld A. Long-term follow up of men born with hypospadias: urological and cosmetic results. J Urol. 2015;193(3):975–81.CrossRefPubMedGoogle Scholar
  19. 19.
    Olsen LH, Grothe I, Rawashdeh YF, Jørgensen TM. Urinary flow patterns in first year of life. J Urol. 2010;183(2):694–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Olsen LH, Grothe I, Rawashdeh YF, Jørgensen TM. Urinary flow patterns in infants with distal hypospadias. J Pediatr Urol. 2011;7(4):428–32.CrossRefPubMedGoogle Scholar
  21. 21.
    Perera M, Jones B, O’Brien M, Hutson JM. Long-term urethral function measured by uroflowmetry after hypospadias surgery: comparison with an age matched control. J Urol. 2012;188(4 Suppl):1457–62.CrossRefPubMedGoogle Scholar
  22. 22.
    Gupta L, Sharma S, Gupta DK. Is there a need to do routine sonological, urodynamic study and cystourethroscopic evaluation of patients with simple hypospadias? Pediatr Surg Int. 2010;26(10):971–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Ozkurkcugil C, Guvenc BH, Dillioglugil O. First report of overactive detrusor in association with hypospadias detected by urodynamic screening. Neurourol Urodyn. 2005;24(1):77–80.CrossRefPubMedGoogle Scholar
  24. 24.
    Grosos C, Bensaid R, Gorduza DB, Mouriquand P. Is it safe to solely use ventral penile tissues in hypospadias repair? Long-term outcomes of 578 Duplay urethroplasties performed in a single institution over a period of 14 years. J Pediatr Urol. 2014;10:1232–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Damon V, Berlier P, Durozier B, Francois R. Study of the dimensions of the penis from birth to adult age and as a function of testicular volume. Pediatrie. 1990;45(7–8):519–22.PubMedGoogle Scholar
  26. 26.
    Ching CB, Wood HM, Ross JH, Gao T, Angermeier KW. The Cleveland Clinic experience with adult hypospadias patients undergoing repair: their presentation and a new classification system. BJU Int. 2011;107(7):1142–6.CrossRefPubMedGoogle Scholar
  27. 27.
    Cimador M, Vallasciani S, Manzoni G, Rigamonti W, De Grazia E, Castagnetti M. Failed hypospadias in paediatric patients. Nat Rev Urol. 2013;10:657–66.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Carlos Arturo Levi D’Ancona
    • 1
  • Juliano Cesar Moro
    • 1
  • Caio Cesar Citatini de Campos
    • 1
  1. 1.Division of UrologyUniversidade Estadual de Campinas—UNICAMPCampinasBrazil

Personalised recommendations