A closer look at iatrogenic hypospadias. (24th August 2020)

• Record Type: Journal Article
• Authors: Özbey, Hüseyin; Devecioğlu, Değer; Staroverov, Oleg
• Other Names: Agarwal Ashok guestEditor.; Baskaran Saradha guestEditor.; Durairajanayagam Damayanthi guestEditor.; Ramasamy Ranjith guestEditor.; Ko Edmund guestEditor.
• Is Part Of: Andrologia. Volume 53:Number 1(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-08-24
• Subjects: fossa navicularis -- frenulum -- glans penis -- iatrogenic hypospadias -- septum glandis; Andrology -- Periodicals; Infertility, Male -- Periodicals; 616.69
• DOI: 10.1111/and.13803
• Languages: English
• ISSNs: 0303-4569

Abstract

Abstract: Almost all surgical repair techniques for hypospadias include dissection of the glans penis, and covering the neo‐urethra with the glans tissue circumferentially. Surprisingly, the presence of the "septum glandis" in the ventral midline has been overlooked for decades. A careful examination of six patients with iatrogenic hypospadias (IH) revealed direct indications of the septum glandis. All patients were treated with long‐term urethral catheterisation in the paediatric intensive care unit due to neurologic and/or metabolic diseases. The glans was disrupted in all patients due to ventral midline compression of the urethral catheter, which resulted in a tear in the septum glandis. A remnant of the septum glandis was clearly observed in patients with an incomplete tear. Further injuries caused tear in the frenulum and corpus spongiosum, exposed the glanular urethra and made its vertical elliptical shape, the "fossa navicularis", visible. Intact contours of the separated glans wings were observed in all patients. The glans wings merge ventrally in the midline, but are separated by a fine connective tissue (septum glandis) in conjunction with the frenulum, which is involved in the formation of the ventral wall of the glanular urethra. IH provides further insight into the structural anatomy of the normal human glans and glanular urethra.