The goal of hypospadias surgery is to reconstruct a penis that is both functional and cosmetically appealing. With the advancement of hypospadias techniques, functional outcome has been less concerning, thus highlighting the patient and parent’s concerns of cosmetic outcomes. There is currently limited research for preoperative counseling of children and their parents on the quality of life, specifically the cosmetic expectations post repair of hypospadias.

A total of 23 participants who underwent hypospadias repair from January 2022 to June 2024 were scored using the GMS classification involving urethral plate quality, meatal location and degree of curvature. Postoperatively, Pediatric Penile Perception Score (PPPS) was used to assess satisfaction in surgical outcomes as determined by the patient/parents with respect to penile length, position and shape of meatus, shape of the glans, shape of penile skin and general appearance of the penis.

From March 2022 - June 2024, 23 patients, of whom 19 were in prepubertal age and 4 were in pubertal ages, who underwent hypospadias repair were included in the study. Eight patients had single stage repair, while 15 boys had 2-stage repair. Urethral locations were divided into proximal (N=15), middle (N=7) and distal (N=1). GMS scores were determined by retrieving measurements taken intraoperatively. These included the urethral plate (Mean=0.45), glans size (Mean=1.73), chordee (Mean=51.74), testis (M =Right - 2.14, Left - 2.2.26) and penile length (Mean=3.35). After analysis, urethral plate (p = 0.041), chordee (p = 0.020) and GMS scoring (p = 0.040) were significant predictors of cosmetic outcomes.

Irrespective of age, urethral location, and the stage of repair, the GMS score is a significant predictor of favorable acceptance regarding genital appearance in patients who have undergone hypospadias repair. Predictors of optimal penile appearance included urethral plate quality and degree of chordee.