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Objective: Anthropometric variants in prepubertal boys with hypospadias were assigned and assessed to illustrate anatomical malformation., Methods: A total of 516 prepubertal (Tanner grade Ⅰ) boys with hypospadias who were admitted to three medical centers between March 2021 and December 2021 and met the selection criteria for primary surgery were selected. The age of the boys ranged from 10 to 111 months, with an average of 32.6 months. Hypospadias were classified according to the location of the urethral defect, 47 cases (9.11%) of the distal type (the urethral defect is in the coronal groove or beyond), 208 cases (40.31%) of the middle type (the urethral defect is in the penis body), and 261 cases (50.58%) of the proximal type (the urethral defect is at the junction or proximal side of the penis and scrotum). The following indexes were measured: penis length before and immediately after operation, reconstructed urethral length, and total urethral length. Morphological indicators of the glans area, including preoperative height and width of glans, AB, BC, AE, AD, effective AD, CC, BB, the urethral plate width of the coronal sulcus, and postoperative height and width of glans, AB, BE, and AD. In which point A is the distal endpoint of navicular groove, point B is the protuberance lateral to the navicular groove, point C is the ventrolateral protuberance of the glans corona, point D is the dorsal midline point of the glans corona, and point E is the ventral midline point of the coronal sulcus. The foreskin morphological indicators, including the foreskin width, inner foreskin length, and outer foreskin length. The scrotal morphological indicators, including the left, right, and front penile to scrotum distance. The anogenital distances, including anoscrotal distance 1 (ASD1), ASD2, anogenital distance 1 (AGD1), and AGD2., Results: The penis length of the distal, middle, and proximal types decreased successively before operation, the reconstructed urethral length increased successively and the total urethral length decreased successively, these differences were all significant ( P <0.05). The height and width of the glans of the distal, middle, and proximal types significantly decreased successively ( P <0.05), but the height/width of the glans was generally close; AB value, AD value, and effective AD value significantly decreased successively ( P <0.05); there was no significant difference in BB value, urethral plate width of the coronary sulcus, and (AB+BC)/AD value between the groups ( P >0.05). There was no significant difference in the width of glans between the groups after operation ( P >0.05); AB value and AB/BE value increased successively, and AD value decreased successively, these differences were all significant ( P <0.05). The inner foreskin length in the 3 groups significantly decreased successively ( P <0.05), while the outer foreskin length had no significant difference ( P >0.05). The left penile to scrotum distance of middle, distal, and proximal types significantly increased successively ( P <0.05). ASD1, AGD1, and AGD2 significantly decreased from distal type to proximal type successively ( P <0.05). The other indicators' differences were significant only between some groups ( P <0.05)., Conclusion: The anatomic abnormalities of hypospadias can be described by anthropometric indicators, which can be used as the basis for further standardized surgical guidance.

Objective: To investigate the effectiveness of penile up transfer method in the treatment of penoscrotal transposition (PST) in children., Methods: A clinical data of 46 children with PST admitted between January 2015 and March 2021 and met selective criteria was retrospectively analyzed. The M-shaped scrotal flap method was adopted in 21 cases (group A), and the penile up transfer method was adopted in 25 cases (group B). There was no significant difference in age and PST typing between the two groups ( t =0.491, P =0.626; χ 2 =0.710, P =0.790). The operation time and postoperative complications of the two groups were recorded and compared, and the correction effect of PST was evaluated., Results: All operations were successfully completed, and no urethral injury occurred during operation. The operation time was significantly less in group B than in group A [(70.36±9.76) minutes vs . (96.62±13.18) minutes; t =7.553, P =0.000]. All children were followed up 6-33 months (mean, 13.2 months). There were 5 cases (23.8%) of skin necrosis and 6 cases (28.6%) of scar hyperplasia in group A, and 1 case (4.0%) of skin necrosis and 1 case (4.0%) of scar hyperplasia in group B. The incidence of complication was significantly lower in group B than in group A ( χ 2 =3.949, P =0.047; χ 2 =5.341, P =0.021). In the evaluation of PST correction at 6 months after operation, there were 15 cases of complete correction and 6 cases of incomplete correction in group A, 24 cases of complete correction and 1 case of incomplete correction in group B, and the difference was significant ( χ 2 =5.341, P =0.021)., Conclusion: The penis up transfer method is not only easy to correct PST, but also can correct scrotal separation at the same time, with fewer postoperative complications and satisfactory correction effect of penile scrotal appearance.

Objective: To discuss the effectiveness of modified Brisson surgery in treatment of the severe and obviously obese concealed penis., Methods: A clinical data of 96 boys with severe concealed penis, of 53 cases combined with obviously obese, who were treated by modified Brisson surgery between January 2014 and August 2016, was retrospectively analysed. The children ranged in age from 1 year to 11 years and 9 months, with an average of 5 years and 3 months. The median longitudinal incision of the penis scrotum was used instead of the wedge-shaped skin incision at the junction of the penis and scrotum, which could completely expose the surgical field; fully release and removal of the abnormal meat membrane and fascia around the penis were performed; the propulsion and rotating flaps match the inner sheath of the foreskin was used to completely remove skin stenosis. Postoperative effectiveness was evaluated by Boemers standard., Results: All the incisions healed by first intention and no infection or necrosis of the foreskin flap occurred. Ninety-three cases were discharged from hospital after operation and followed up 1 year to 3 years and 6 months, with an average of 2 years and 4 months. Scrotal hematoma occurred in 2 cases within 48 hours, penile skin edema occurred in 5 cases, and scar hyperplasia in the penis scrotal corner incision occurred in 1 case at 1 month after operation. Postoperative exposure of the penis was good in 90 cases; there was no retraction of the penis in the upright position and sitting position; the family members were satisfied with the appearance of the penis. The penis were partially retracted in 3 cases, that affected the appearance of the penis during the sitting position., Conclusion: The modified Brisson surgery is one of the most effective methods to treat the severe and obviously obese concealed penis, with satisfactory effectiveness and less complication.