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Hypospadia is the most common congenital anomaly of the penis and urethra, affecting 1:300 male born. In patient with Hypospadias the external urinary meatus is not located at the apex of the glans but along the penile shaft or scrotum. For this reason different types of hypospadias have been described: Glandular, Balanic, Penile, Peno-Scrotal, Scrotal and Perineal.
The foreskin on the ventral penile surface is deficient, while the part of foreskin on the dorsal surface is abundant, giving the appearance of a dorsal hood. Chordee or penile curvature can be also present, and is more common in severe cases. Cryptorchidism and inguinal hernia are the most common associated anomalies.
Hypospadia is associated with glans, penile skin and corpora cavernosa anomalies. The diagnosis of hypospadia is made on the first days of life. The ideal age for surgical repair in a healthy child is between 6 and 12 months of age.

Failed Hypospadias

The results of Hypospadias surgical correction in children are satisfactory but when children reach sexual maturity (following the puberty) they may develop surgery-related complications following correction during childhood. The most frequent complications in adult patients who underwent an early repair are: urethral stricture, meatal stricture, fistula, retrusive meatus, residual penile curvature, diverticulum, hair-growth in the urethra, stone, glans malformation, penile skin malformation. The surgical repair of these complications still represents one of the most difficult problems in Urology. Adults with complications following an early hypospadia repair are still a difficult population to treat which is associated with a high failure rate for reoperative surgery.