HYPOSPADIAS SURGERY

In hypospadias surgery, tubularization of the neourethra over a catheter or stent and approximation of the dissected glans wings on the midline to enclose the neourethra have been the standard surgical method for decades. However, the male urethra is not a tubular structure with uniform configuration and diameter. The "fossa navicularis" (terminal/glanular portion of the male urethra) has distinct attachments with the "septum glandis" and "frenulum". Recently, we documented the anatomical features of the glans penis with MRI study. In accordance with previous historical drawings of the glans penis, our findings revealed that a fibrous tissue (septum glandis) covers the glanular urethra (fossa navicularis) circumferentially. It binds the fossa navicularis to the frenulum and corpus cavernosum, as a suspensory ligament on the midline. Hence, it may be true to say that reconstruction of the glanular urethra has been far from its normal anatomical features for decades.

The GFC technique is a turning point in hypospadias surgery, which is based on the anatomical features of the penis that are not taken into account since decades. With the GFC technique, the anatomical features of the glanular urethra, in particular the "fossa navicularis", "septum glandis", "frenulum" and the "shape of the normal urine stream" are taken into account for the first time. As being the most anatomical repair, the GFC technique gives the most effective and satisfactory results in hypospadias.