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Classification of hypospadias based on physical findings*

Classification of hypospadias based on physical findings*
Classification Approximate relative frequency (%) Ectopic urethral location Penile curvature Foreskin appearance Management
Forme fruste of hypospadias (incomplete or partial presence of hypospadias) 10 Normal location with a urethral pit or ectopic urethra on the distal glans Normal Normal to mild asymmetric ventral deficiency (incomplete closure around the glans)
  • No surgical correction or further evaluation needed
Standard hypospadias with normal glans width (maximal diameter ≥14 mm) 40 Distal urethral location on glans or coronal margin Normal to mild Ventral deficiency with a dorsal hooded appearance
  • Surgical correction in most cases, however, families may choose observation
  • No other evaluation
25 Proximal urethral location on penile shaft, at the penoscrotal junction, or within the scrotum Moderate Ventral deficiency with a dorsal hooded appearance
  • Surgical correction required
  • No other evaluation
Severe with an abnormally small glans (maximal diameter <14 mm) 20 Scrotum or perineum with an abnormally small glans (maximal diameter <14 mm) Severe Ventral penile foreskin tethering (referred to as short urethral plate) or fusion of the foreskin to the scrotum
  • Surgical correction required (usually two-stage procedure)*
  • Endocrine evaluation to detect disorders of sex development*
Other variants 5  
Chordee without hypospadias   Normal urethral opening and glans Mild to severe Normal
  • Surgical correction of chordee
  • No other evaluation
Megameatus intact prepuce   Large urethral opening at the coronal margin Normal Normal
  • Correction is usually performed based on family preference
  • No other evaluation
* This table is meant for use with UpToDate content on hypospadias. For further details regarding the diagnosis and management of hypospadias, refer to the UpToDate topics on hypospadias.
¶ Penile curvature is assessed when the penis is erect and classified as normal (0 to 15 degrees), mild (15 to 40 degrees), moderate (40 to 80 degrees), and severe (>80 degrees).
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