This study delves into the variations in glans penis size among newborn and infant males, specifically comparing those with and without hypospadias, a congenital condition where the opening of the urethra is misplaced. Hypospadias is categorized into distal (near the glans) and proximal (further down the penis shaft) types. The research aims to establish reference points for glans size in these different groups.
This research involved a prospective measurement of the maximum glans diameter in boys aged 0-24 months. The participants were divided into three groups: a control group of newborns undergoing elective circumcision, boys undergoing repair for distal hypospadias, and boys undergoing repair for proximal hypospadias. For boys with proximal hypospadias and a glans diameter less than 14 mm, testosterone injections were administered to enhance glans size before surgery. Measurements were taken before the testosterone treatment and again intra-operatively after the treatment.
The study gathered data from 240 control infants, 188 boys with distal hypospadias, and 39 boys with proximal hypospadias. The median ages were 1, 9, and 9 months for the control, distal, and proximal hypospadias groups, respectively. The control group was significantly younger than both hypospadias groups. The average maximum glans diameters showed significant differences across the groups. Control newborns averaged 14.3 mm, boys with distal hypospadias 14.8 mm, and boys with proximal hypospadias 12.9 mm. Notably, despite being older on average, a considerable portion of boys with hypospadias had a smaller glans diameter (<14 mm): 24.5% in the distal group and a significant 61.5% in the proximal group. The study also found that increasing age between 3 and 24 months did not correlate with an increase in glans size in either hypospadias group.
In conclusion, the research highlights that a notable proportion of boys with distal hypospadias and the majority with proximal hypospadias present with a glans width smaller than the average newborn. The lack of correlation between glans size and age in boys with hypospadias aged 3 to 24 months provides support for performing surgical correction as early as 3 months of age in specialized centers. This comparative analysis of penile dimensions offers valuable reference data for clinicians managing hypospadias.
