Repair of the Bulbospongiosus Muscle to Suspend the Penis to the Pubic Bones in Proximal Hypospadias

jpedsurg.org

In proximal hypospadias, ventral curvature is invariable and most have penoscrotal transposition, and we observed that the base of the penis (BOP) was located on the inferior aspect of the pubic bones in those, in contrast to the location of the BOP at the anterior end in normal penises. We also observed an unfused bulbospongiosus muscle (BSM) at surgery in those. The aim was to assess the impact of repairing the unfused BSM or transection and straightening of the urethral plate at the first operation on the low BOP.

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Article · Nov 2024 · 1 min read

In brief

This study examines surgical techniques for correcting anatomical abnormalities in proximal hypospadias, specifically addressing the low position of the penile base relative to pubic bones. The authors compare outcomes of bulbospongiosus muscle repair versus urethral plate transection to improve penile positioning in patients with penoscrotal transposition and ventral curvature.

Proximal hypospadias patients have the base of the penis located inferiorly on pubic bones, not anteriorly as in normal anatomy.
Unfused bulbospongiosus muscle is consistently observed intraoperatively in proximal hypospadias with penoscrotal transposition.
Repairing the unfused bulbospongiosus muscle may correct the abnormally low penile base position during first-stage surgery.
Ventral curvature and penoscrotal transposition are invariable features in proximal hypospadias cases.

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