Assessment of urethral plate appearance through digital photography: Do pediatric urologists agree in their visual impressions of the urethral plate in children with hypospadias?

Width proportion of the urethral plate to the glans can serve as an appraisal index of the urethral plate in hypospadias repair

“…However, the subjectivity means that it is not precise enough for evaluating such an important element for hypospadias. Indeed, previously, the method had been thought to lack agreement on subjectivity, irrespective of the level of the defect or surgeon experience …”

“…Indeed, previously, the method had been thought to lack agreement on subjectivity, irrespective of the level of the defect or surgeon experience. 17 Meatal location was a remarkably unanimous factor influencing outcomes in hypospadias surgery. 18,19 The present data showed that glans width was significantly correlated to meatal location, but U/G was not.…”

Failed hypospadias in paediatric patients

“…19,20 Moreover, the assessment of urethral plate characteristics seems to be somewhat subjective, with wide interobserver variability. 21 It is worth noting that some anatomical characteristics-such as the presence of a short penis, which is relatively common in patients with proximal hypospadias-can cause dissatisfaction in the absence of complications. It can be very difficult to assess the effect of these characteristics on the success of repair.…”

Can We Correct Hypospadias with a Staged Operation? If not, are We Bold Enough to Report it?

“…6,7 Even digital photography may not decrease the subjectivity of assessment of this art/science of hypospadiology, but if standardized, digital imaging will likely lead to better segregation of subjects and more precise reporting of outcomes. 8 Most of all, we need to structure our followup assessment to include the parent and, if appropriate, the patient. Our impressions do not always agree with those of the families.…”