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Morphology of hypospadias.

Morphological investigation was performed in a clinical series for prospective study comprising 220 unselected cases of hypospadias. The patients were followed up postoperatively for 8 to 12 years. The investigation comprised the external and internal genitals, including anomalies of the testes and disturbances in gonad differentiation, and simultaneous malformations in the upper urinary tract and extraurogenital malformations. At the preoperative examination the meatal caliber was judged to be inadequate in 91% of the patients with glandular hypospadias, the mildest and commonest form. Curvature was observed in 69% and torsion in 16%. Manifest penile hypoplasia was registered in 7/220, 3 of whom showed chromosomal aberrations. Among the congenital anomalies of the proximal urethra, undevelopment of the prostate was discovered in one perineal hypospadiac and absence of the internal sphincter mechanism in one glandular and one perineal hypospadiac among 142/220 who had reached fertile age. The anomaly in these three patients caused retrograde ejaculation.