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Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

Index
Original Article
Hypospadias scoring challenges: a pilot study on GMS interpretation
Aims: Hypospadias is one of the most common urological congenital anomalies. Several scoring systems have been established to create a common language for hypospadias because the severity, determined only according to meatus localisation, does not provide an accurate approach. Glans-urethral meatus shaft (GMS) scoring is one of them.
Methods: This pilot study’s purpose was to determine how to improve the GMS score (3-12) and if it would be beneficial to divide the three-part structure (mild, moderate, severe) into two groups: high and low scores. Our study was planned and conducted as a one-year prospective study, and 44 cases were included in this study.
Results: Conventional groups were regrouped as the Low score group, including GMS 3-7 scores, and the High score group, including GMS 8-12 scores. High score group was statistically significantly higher than Low score group regarding the presence of complications (p=0.021). No significant correlation was found between glans and penis measurements and development of complications.
Conclusion: Our study suggests that the simpler two-category method we proposed for the evaluation of the GMS score may also be an alternative. It suggests the need for further studies to evaluate and improve the utility of all scoring methods, including the GMS.


1. Schneuer FJ, Holland AJA, Pereira G, Bower C, Nassar N. Prevalence, repairs and complications of hypospadias: an Australian population-based study. Arch Dis Child. 2015;100(11):1038-1043.
2. Springer A, van den Heijkant M, Baumann S. Worldwide prevalence of hypospadias. J Pediatr Urol. 2016;12(3):152.e1-152.e7.
3. Snodgrass W, Macedo A, Hoebeke P, Mouriquand PDE. Hypospadias dilemmas: a round table. J Pediatr Urol. 2011;7(2):145-157.
4. Chaudhary G, Yhoshu E, Chauhan U, et al. Anatomical study of hypospadias penis using magnetic resonance imaging in children. J Pediatr Urol. 2022;18(1):57.e1-57.e7.
5. Orkiszewski M. A standardized classification of hypospadias. J Pediatr Urol. 2012;8(4):410-414.
6. Hadidi, AT. Hypospadias surgery: an illustrated textbook second edition. 2nd ed. Springer Netherlands; 2022.
7. Giannantoni A. Hypospadias classification and repair: the riddle of the sphinx. Eur Urol. 2011;60(6):1190-1191.
8. Arlen AM, Kirsch AJ, Leong T, Broecker BH, Smith EA, Elmore JM. Further analysis of the glans-urethral meatus-shaft (GMS) hypospadias score: correlation with postoperative complications. J Pediatr Urol. 2015;11(2):71.e1-71.e5.
9. Merriman LS, Arlen AM, Broecker BH, Smith EA, Kirsch AJ, Elmore JM. The GMS hypospadias score: assessment of inter-observer reliability and correlation with post-operative complications. J Pediatr Urol. 2013;9(6): 707-712.
10. Sheng X, Xu D, Wu Y, Yu Y, Chen J, Qi J. The risk factors of urethrocutaneous fistula after hypospadias surgery in the youth population. BMC Urol. 2018; 18(1):64.
11. Wu Y, Wang J, Zhao T, et al. Complications following primary repair of non-proximal hypospadias in children: a systematic review and meta-analysis. Front Pediatr. 2020;8:579364.
12. Bush NC, Holzer M, Zhang S, Snodgrass W. Age does not impact risk for urethroplasty complications after tubularized incised plate repair of hypospadias in prepubertal boys. J Pediatr Urol. 2013;9(3):252-256.
13. Prat D, Natasha A, Polak A, et al. Surgical outcome of different types of primary hypospadias repair during three decades in a single center. Urology. 2012;79(6):1350-1354.
14. Hisamatsu E, Sugita Y, Haruna A, Shibata R, Yoshino K. The learning curve in proximal hypospadias repair. J Pediatr Urol. 2021;17(3):330.e1-330.e6.
15. Spinoit AF, Poelaert F, Groen LA, Van Laecke E, Hoebeke P. Hypospadias repair at a tertiary care center: long-term followup is mandatory to determine the real complication rate. J Urol. 2013;189(6):2276-2281.
16. Bush NC, Snodgrass W. Pre-incision urethral plate width does not impact short-term tubularized incised plate urethroplasty outcomes. J Pediatr Urol. 2017;13(6):625.e1-625.e6.
17. Sarhan O, Saad M, Helmy T, Hafez A. Effect of suturing technique and urethral plate characteristics on complication rate following hypospadias repair: a prospective randomized study. J Urol. 2009;182(2):682-686.
18. Sozubir S, Snodgrass W. A new algorithm for primary hypospadias repair based on tip urethroplasty. J Pediatr Surg. 2003;38(8):1157-1161.
19. Abbas TO, Braga LH, Spinoit AF, Salle JP. Urethral plate quality assessment and its impact on hypospadias repair outcomes: a systematic review and quality assessment. J Pediatr Urol. 2021;17(3):316-325.
20. Holland AJA, Smith GHH. Effect of the depth and width of the urethral plate on tubularized incised plate urethroplasty. J Urol. 2000;164(2):489-491.
21. Bush NC, Villanueva C, Snodgrass W. Glans size is an independent risk factor for urethroplasty complications after hypospadias repair. J Pediatr Urol. 2015;11(6):355.e1-355.e5.
22. Faasse MA, Johnson EK, Bowen DK, et al. Is glans penis width a risk factor for complications after hypospadias repair? J Pediatr Urol. 2016;12(4):202.e1-202.e5.
23. Sennert M, Wirmer J, Hadidi AT. Preoperative glans & penile dimensions in different hypospadias grades. J Pediatr Urol. 2022;18(1):47-53.
24. Huang J, Rayfield L, Broecker B, et al. High GMS score hypospadias: outcomes after one- and two-stage operations. J Pediatr Urol. 2017;13(3): 291.e1-291.e4.
25. Shoukry A, Abbas A, Abdelwahab M, et al. Glans-urethral meatus-shaft score and penile parameters as preoperative assessment tools for hypospadias surgery outcome. Afr J Urol. 2021;27(1):102.
26. Abbas TO. An objective hypospadias classification system. J Pediatr Urol. 2022;18(4):481.e1-481.e8.
27. Castagnetti M, El-Ghoneimi A. Surgical management of primary severe hypospadias in children: systematic 20-year review. J Urol. 2010;184(4): 1469-1475.
28. Long CJ, Canning DA. Proximal hypospadias: we aren’t always keeping our promises. F1000Res. 2016;5:2379.
Volume 1, Issue 4, 2024
Page : 84-88
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