J. Fichtner et al., ANALYSIS OF MEATAL LOCATION IN 500 MEN - WIDE VARIATION QUESTIONS NEED FOR MEATAL ADVANCEMENT IN ALL PEDIATRIC ANTERIOR HYPOSPADIAS CASES, The Journal of urology, 154(2), 1995, pp. 833-834
The high incidence (70%) of anterior hypospadias, mostly without penil
e curvature, in our pediatric hypospadias patients led us to study the
meatal location in normal men to investigate if meatal advancement in
all patients with anterior hypospadias can be justified when the wide
variation of meatal locations in normal men is considered. Tile locat
ion of the external meatus was analyzed in 500 men (mean age 57 years)
with classification of the meatal position in relation to the tip of
the glans and corona. Quality of erections and sexual intercourse, pre
sence or absence of penile curvature, urinary stream and ability to vo
id in a standing position were assessed in an interview. Of the 500 me
n only 275 (55%) were normal with the meat-us in the distal third of t
he glans, while 65 (13%) had anterior hypospadias (glanular in 49, cor
onal in 15 and subcoronal in 1). In 160 men (32%) the urethral meatus
was located in the mid third of the glans. Analyzing coronal and subco
ronal hypospadias further, all but 6 patients were not aware of any pe
nile anomaly, all but 1 homosexual patient have fathered children and
only 1 had penile curvature (subcoronal hypospadias). However, all pat
ients participated in sexual intercourse without problems and were abl
e to void in a standing position with a single stream. In our study of
500 ''normal'' men the meatal location varied widely with only 55% of
all meatus at the tip of the glans and significant hypospadias in pat
ients without complaints about cosmetic or functional aspects. We beli
eve that these observations might question the need for meatal advance
ment in cases of anterior hypospadias without associated penile curvat
ure.