Further analysis of the Glans-Urethral Meatus-Shaft (GMS) hypospadias score: Correlation with postoperative complications

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

“…In 2013, a concise method for evaluating urethral plate quality based on subjective judgment was proposed by Merriman, which had the advantage of being minimally affected by penis size. 7,8 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.…”

“…It might be more appropriate to evaluate urethral plate quality with a parameter scaled with penis size. In recent years, Glans–Urethral Meatus–Shaft score was proposed to classify the severity of hypospadias, providing a concise method for evaluating urethral plate quality . This method is indeed suitable for all, but is subjective and not sufficiently precise.…”

“…In recent years, Glans-Urethral Meatus-Shaft score was proposed to classify the severity of hypospadias, providing a concise method for evaluating urethral plate quality. 7,8 This method is indeed suitable for all, but is subjective and not sufficiently precise. Therefore, it appears necessary to set up an appropriate method for evaluating urethral plate quality objectively and accurately, regardless of penis size.…”

Hypospadias Repair and Its Complications at the Plastic Surgery Department, Khoula Hospital

“…Another Prospective study showed increased likelihood of post-operative complications with increase in GMS scoring [6]. It includes 4 unit scale in each component: G-Glans size glans size/urethral plate quality, M-Meatal location, and S-degree of Shaft curvature, with more unfavourable characteristics assigned higher scores.…”

Current challenges with proximal hypospadias: We have a long way to go

“…They subsequently demonstrated that the GMS score was correlated with post-operative risk of complications with increasing score associated with increasing rate of urethrocutaneous fistula. Mild (GMS 3-6), moderate (GMS 7-9), and severe (GMS 10-12) GMS scores were associated with 2.4%, 11.1%, and 29% fistula rates [36]. Although the types of repairs used were not clarified, this does begin the conversation that surgeons can use preoperative factors to determine surgical approach outside of general "gestalt," which is learned with time and experience.…”