Types of Hypospadias Repaired by the Sava Perovic Foundation
“Type” of hypospadias = location of pee hole.
In the 1,900 years since Celsus started the discussion about hypospadias in 1st century Rome, the global medical community has conjured up more than three dozen confusing terms to specify the abnormal anatomical location where urine exits the urethral hole.
No agreement, clarity or simplification is expected soon. Find the full list of hypospadias types below.
After nearly two millennium, the American Urological Association admits: “we lack a clear-cut definition of severe hypospadias”. (Journal of Urology, Volume 184 (4) pp 1469-1475, October 2010)
So no need to be overly concerned about all these medical terms listed below. Focus on the type of hypospadias relevant to you or your child.
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With the exception of “adult”, “female” and “iatrogenic”, almost all terms used to describe a so-called “type” of hypospadias refer to a basic part of male genitals, the:
- glans
- penile shaft
- scrotum or
- perineum
A “type of hypospadias” refers to a particular point on an imaginary line along the center of the underside of the penis that starts at the tip of it and ends at the anus.
The further the hole is away from the tip of the penis, the more “severe”, the higher the “grade” or the higher the “degree” the hypospadias is given.
It's that simple.
“Mild hypospadias” means the hole is closer to normal location at the tip & center of the glans.
Examples of “mild hypospadias” would be those in the distal hypospadias group such as glanular hypospadias, coronal hypospadias and subcoronal hypospadias.
It's debatable and there is plenty of disagreement about whether subglanular hypospadias and distal penile hypospadias should also be considered “mild hypospadias”. Some doctors categorize them as Grade 2 hypospadias or second degree hypospadias.
“Severe hypospadias” means the hole is furthest away from the center of the tip of the penis glans. “Severe hypospadias” would include perineal hypospadias, scrotal hypospadias, penoscrotal hypospadias and any other referred to as proximal hypospadias, Grade 4 hypospadias or posterior hypospadias.
The main reason surgeons call a hole far from the glans “severe hypospadias” is because of the challenge of creating the missing inches of urethra.
World class surgeon Dr Rados Djinovic (pronounced RAH-DOSH JIN-O-VICH) will inform and assure, not try to amaze you with his medical prowess. He will simply and concisely explain what needs to be done to correct the hypospadias in an excellent, permanent way.
His world class training by “the-best-of-the-best” is combined with extensive experience performing urethroplasty. He frequently creates new urethra (neourethra) up to SEVEN INCHES long for adult patients.
What others call “severe hypospadias”, Dr Djinovic is likely to refer to as penoscrotal hypospadias, scrotal hypospadias or perineal hypospadias. Those types of hypospadias are NOT severe for him. Your child's tiny penis is not going to be a problem.
“Doctor D”, as some patients call him, is also UNlikely to refer to so-called severe hypospadias as Grade 4 hypospadias. It is just more hours of work requiring more concentration, more skill, more experience and the best urogenital reconstructive surgery techniques — especially world class tissue engineering.
Dr Djinovic is lead surgeon and chairman of the Sava Perovic Foundation, a very highly specialized center that creates unique, personalized, customized, world class solutions for urogenital problems — case-by-case.
“The Perovic Art of Urogenital Surgery” enables Doctor D to routinely perform world class operations that achieve supreme surgical results for not only hypospadias correction but also more than 70 other types of genito-urinary afflictions.
National health systems such as those of the UK, Canada & Romania pay to send their most difficult & challenging cases to Dr Djinovic and the world class services of the Sava Perovic Foundation in Belgrade. World class solutions are clearly in the best interest of their citizens. And happy, healthy, productive citizens are in the national interest.
Patients who have suffered bad surgical experiences locally are welcome to have “Doctor D” solve the original hypospadias problem PLUS overcome the bad effects of the previous failed surgeries to the fullest extent possible.
During many years of hands-on, world class training while performing the most challenging and complex urogenital surgery with the legendary Sava Perovic and now as leader of the Perovic surgical team, Dr Djinovic has acquired about 24,000 hours of surgical experience — more than most surgeons get in a lifetime.
Dr Djinovic corrects all the types of hypospadias listed below as well as those not mentioned. Most hypospadias repair can be completed in a single surgical session.
- adult hypospadias
- balanic hypospadias
- bulbar hypospadias
- coronal hypospadias (urethra immediately below glans, mild)
- distal hypospadias (away from the point of penile attachment)
- female hypospadias
- first degree hypospadias (mild, grade1, subcoronal)
- glanular hypospadias (urethra within penis head [glans])
- glandular hypospadias (frequent misspelling of glanular)
- grade 1 hypospadias
- grade 2 hypospadias
- grade 3 hypospadias
- grade 4 hypospadias
- hypospadias chordee (when both appear together)
- iatrogenic hypospadias (not hypospadias)
- isolated hypospadias (non-syndromic)
- megameatus hypospadias (hole starts in right place but extends down to corona, less than 5% of all hypospadias cases, “megas” = huge [Greek])
- megameatus intact prepuce (MIP) hypospadias
- midshaft hypospadias
- mild hypospadias (1st degree, grade 1, subcoronal)
- midpenile hypospadias
- minor hypospadias
- moderate hypospadias (2nd degree)
- non-syndromic hypospadias (no other problems except chordee, hernia, cryptorchidism)
- pendulous hypospadias
- penoscrotal hypospadias (urethra close to scrotum, grade 4)
- penile hypospadias (urethra on penis shaft, grade 3, midshaft)
- perineal hypospadias
- perineoscrotal hypospadias
- proximal hypospadias
- retrograndular hypospadias
- scrotal hypospadias
- second degree hypospadias
- severe hypospadias
- stem hypospadias
- subcoronal hypospadias (urethra immediately below glans)
- subglanular hypospadias (subcoronal, just below glans)
- syndromic hypospadias (involves other defects of varying severity, excludes chordee, hernia, cryptorchidism)
- third degree hypospadias
- traumatic hypospadias
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