CLARIFYING THE DILEMMAS OF HYPOSPADIAS CLASSIFICATION

Authors

  • Dëfrim Koçinaj PhDc pediatric surgeon, University Clinical Center of Kosovo, Department of Pediatric Surgery
  • Lazar Todorovic Prof Dr, pediatric surgeon, Department of Pediatric Surgery, Faculty of Medicine, University "St. Cyril and Metodij”, Skopje, Republic Northern Macedonia
  • Shaban Memeti Prof Dr, pediatric surgeon, Department of Pediatric Surgery, Faculty of Medicine, University "St. Cyril and Metodij”, Skopje, Republic Northern Macedonia
  • Marjan Kamilovski Prof Dr, pediatric surgeon, Department of Pediatric Surgery, Faculty of Medicine, University "St. Cyril and Metodij”, Skopje, Republic Northern Macedonia
  • Era Salihu Fourth-year student, Faculty of Medicine, University of Pristina, Kosovo

DOI:

https://doi.org/10.58885/ijllis.v14i1.53dk

Keywords:

hypospadias, classification, chordee, surgical treatment, intraoperative evaluation.

Abstract

Introduction: Hypospadias is a congenital penile anomaly characterized by an abnormal urethral meatus position, penile curvature (chordee), and a ventrally deficient foreskin. Existing classifications often overlook crucial surgical factors such as urethral plate width and chordee severity, leading to inconsistencies in surgical decision-making. A more objective intraoperative classification is essential for accurate evaluation and treatment planning.

Objective: This study aims to determine the most effective hypospadias classification system by analyzing published literature and clinical cases, with a focus on intraoperative assessment.

Materials and Methods: This prospective study analyzed 60 pediatric hypospadias patients treated at the University Clinical Center of Kosovo from February to October 2023. Intraoperative classification was performed via a form based on Prof. Dr. Ahmed Hadidi’s system. Additionally, a retrospective review of the relevant literature was conducted to identify the most appropriate classification approach.

Results: Of the 60 patients, 20 (33.3%) had glandular hypospadias, and 40 (66.7%) had distal penile hypospadias preoperatively. A complete foreskin was found in 7 (11.7%) patients, whereas 53 (88.3%) patients had an incomplete foreskin. Chordees were absent in 23 (38.3%), superficial in 31 (51.7%), and deep in 6 (10%) patients. The urethral plate width was <1 cm in 42 (70%) cases and ≥1 cm in 18 (30%) cases. The glans presented included 11 (18.3%) cleft glans, 44 (73.3%) partial cleft glans, and 5 (8.3%) flat glans. Torsion was absent in 52 (86.7%) patients. Scrotal transposition was noted in 2 (3.3%) patients.

Conclusions: A comprehensive classification incorporating all anatomical elements enhances surgical decision-making and standardizes anomaly descriptions for global communication. Anterior hypospadias (subcoronal and glandular) is the most common type and is often associated with incomplete foreskin and chordee, reinforcing the need for precise classification.

References

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Published

2025-02-24 — Updated on 2025-03-17

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How to Cite

Dëfrim Koçinaj, Lazar Todorovic, Shaban Memeti, Marjan Kamilovski, & Era Salihu. (2025). CLARIFYING THE DILEMMAS OF HYPOSPADIAS CLASSIFICATION. ANGLISTICUM. Journal of the Association-Institute for English Language and American Studies, 14(1), 53–61. https://doi.org/10.58885/ijllis.v14i1.53dk (Original work published February 24, 2025)

Issue

Vol. 14 No. 1 (2025)

Section

INTERDISCIPLINARY STUDIES

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