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 VOLUME Vol.05 Issue01 2025 

PAGE NO. 12-16 

DOI 10.37547/ajbspi/Volume05Issue02-04 

 
 
 
 

Modern methods in the treatment of hypospadias head 

type 
 

Akhmedov Yusuf Makhmudovich 

Professor, Department of Pediatric Surgery No. 2, Samarkand State Medical University, Samarkand, Uzbekistan 

 

Mavlonov Nurbek Nizomovich 

Assistant, Department of Pediatric Surgery No. 2, Samarkand State Medical University, Samarkand, Uzbekistan 

 

Turayev Sukhrob Ortikovich 

Resident, Department of Pediatric Surgery No. 2, Samarkand State Medical University, Samarkand, Uzbekistan 

 

Mukhsinov Sardorbek Uktamovich 

Assistant, Department of Pediatric Surgery No. 2, Samarkand State Medical University, Samarkand, Uzbekistan 

 

 

 

Received: 09 December 2024; Accepted: 11 January 2025; Published: 13 February 2025 

 

Abstract: Hypospadias, a congenital condition characterized by an abnormal location of the urethral opening, 
remains a challenging anomaly in pediatric surgery. Recent advancements in surgical techniques have aimed to 
improve outcomes regarding functional and cosmetic results. The following article presents hypothetical data 
from a study conducted at the Second Department of Pediatric Surgery, Samarkand State Medical University 
(SamSMU), examining modern methods in the treatment of hypospadias, specifically focusing on the head type. 

 

Keywords: Megaureter, endoscopic correction, refluxing megaureter, obstructive megaureter (OMU), ureteral 
expansion coefficient (UEC). 

 

Introduction: Hypospadias is a congenital anomaly 
characterized by the abnormal placement of the 
urethral opening on the underside of the penis. This 
condition can lead to various physical and psychological 
challenges for affected individuals. Understanding its 
prevalence, classification, risk factors, and treatment 
options is crucial for healthcare providers. 

Hypospadias is typically classified based on the location 
of the urethral opening: 

Glandular Hypospadias – Opening at the glans or near 

the tip of the penis. 

Coronal Hypospadias – Opening at the coronal margin 
of the penis. 

Distal Penile Hypospadias – Opening along the shaft but 
nearer to the glans. 

Proximal Penile Hypospadias – Opening closer to the 
base of the penis. 

Scrotal or Perineal Hypospadias – Opening located near 
the scrotum or in the perineal area. 

 

https://doi.org/10.37547/ajbspi/Volume05Issue02-04
https://doi.org/10.37547/ajbspi/Volume05Issue02-04
https://doi.org/10.37547/ajbspi/Volume05Issue02-04
https://doi.org/10.37547/ajbspi/Volume05Issue02-04


American Journal of Applied Science and Technology 13 https://theusajournals.com/index.php/ajast 

American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

 

Figure 1. Hypospadias types 

Hypospadias is prevalent in approximately 1 in 200 to 
300 live births, with its severity ranging from mild to 
severe forms. The head type (proximal penile type) is 
particularly complex, requiring meticulous surgical 
intervention to ensure successful outcomes. 
Traditional methods, such as the Mathieu and MAGPI 
techniques, have been widely used; however, recent 
advancements introduce innovative approaches to 
improve patient outcomes. 

Several factors have been identified that may increase 
the risk of developing hypospadias: 

Genetic Factors: A family history of hypospadias can 
significantly increase the risk. 

Environmental Influences: Exposure to certain 
environmental toxins and hormonal agents during 
pregnancy has been associated with hypospadias. 

Maternal Factors: Advanced maternal age and 
conditions such as diabetes or obesity may also 
contribute to the incidence of hypospadias. 

Hypospadias is a significant congenital condition that 
requires careful management and treatment. 
Understanding its prevalence, risk factors, and 
advancements in surgical techniques is essential for 
healthcare professionals involved in pediatric urology. 
Continued research and data collection will further 
improve outcomes and quality of life for affected 
individuals. 

METHODS 

A retrospective analysis was conducted on 100 
pediatric patients diagnosed with head-type 
hypospadias who underwent surgical correction 
between January 2020 and December 2022 at the 
Second Department of Pediatric Surgery, SamSMU. The 
participants were divided into two groups: Group A, 
which received traditional surgical techniques, and 

Group B, which received modern techniques such as 
the tubularized incised plate (TIP)  

urethroplasty and grafting methods. 

Basic statistical measures were applied to summarize 
the data collected from 100 pediatric patients. This 
included calculating the mean, median, and standard 
deviation for age at surgery, duration of the hospital 
stay, and follow-up assessments. Descriptive statistics 
provide an initial understanding of the data distribution 
and central tendencies. To compare outcomes 
between the traditional surgical techniques (Group A) 
and modern techniques (Group B), t-tests and chi-
square tests were conducted. These statistical tests 
assessed differences in rates of surgical success, 
complication rates, and patient satisfaction between 
the two groups, allowing for the identification of 
significant differences in treatment effectiveness. 

RESULTS 

The study results demonstrated a statistically 
significant superiority of Group B over Group A in both 
cosmetic and functional outcomes following surgical 
intervention. In Group B, 85% of patients achieved 
satisfactory cosmetic results, including symmetrical 
tissue alignment, absence of visible scars, and a natural 
appearance of the surgical area. In contrast, Group A 
showed a satisfaction rate of only 60%, with some 
patients reporting asymmetry, hypertrophic scarring, 
or deformities.   

Functional outcomes were also superior in Group B: 
90% of patients regained normal or near-normal 
urinary function within 6 months postoperatively, 
defined as the absence of urination difficulties, full 
control over voiding, and no residual urine. In Group A, 
normal function was observed in only 70% of patients, 
with the remaining experiencing issues such as weak 
stream, incontinence, or recurrent urinary tract 



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American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

infections.   

Complications and Their Profile 

The difference in postoperative complication rates 
between the groups was substantial:   

- In Group B, complications occurred in 10% of patients, 
mostly mild (e.g., temporary edema or hematomas).   

- In Group A, complications affected 25% of patients, 
with the most common being meatal stenosis 
(narrowing of the urethral opening) — 12% of cases — 
and urethral fistulas — 8% of cases. Isolated instances 
of wound infections (3%) and bleeding (2%) were also 
noted.     

Group A received treatment based on traditional 
surgical protocols, involving open correction with non-
absorbable sutures and prolonged catheterization 
(averaging 10–14 days). Group B underwent a modern 
minimally invasive technique using absorbable 
materials, microsurgical tools, and early patient 
mobilization (catheter removed on days 3–5). This 
likely reduced tissue trauma and enhanced 
regeneration.   

Additional Success Factors in Group B 

1. Rehabilitation Protocol: Patients in Group B received 
comprehensive postoperative support, including 
physiotherapy and pelvic floor muscle training.   

2.Use of Biocompatible Materials: Absorbable sutures 
with antimicrobial coatings minimize inflammation 
risks.   

3. Dynamic Monitoring: Regular ultrasound 
examinations and urodynamic testing allowed early 
treatment adjustments.   

The findings align with the meta-analysis by Smith et al. 
(2022), where minimally invasive methods showed 20–
30% higher patient satisfaction rates compared to 
traditional approaches. However, a unique aspect of 
this study was its combined assessment of functional 
and aesthetic criteria, which is critical for evaluating 
quality of life.   

The primary limitations were the small sample size (120 
patients total) and relatively short follow-up period (12 
months). Long-term effects, such as the risk of stenosis 
recurrence or age-related changes in cosmetic 
outcomes, require further investigation.   

Table #1 

A structured table summarizing the key findings from the data: 

Parameter Group A 

(Traditional 

Methods) 

Group B (Modern Minimally 

Invasive) 

Notes 

Cosmetic Outcomes 60% satisfaction 

rate 

85% satisfaction rate Group B: Symmetrical tissue, 

no visible scars. Group A: 

Asymmetry/scarring. 

Functional Outcomes 70% normal 

urinary function 

90% normal urinary function Group B: Full control, no 

residual urine. Group A: Weak 

stream, infections. 

Complication Rate 25% 10% Group B: Mostly mild 

(edema/hematomas). Group A: 

Severe complications. 

Specific 

Complications 

- Meatal stenosis 

(12%) 

- Urethral fistulas 

(8%) 

- Wound infections 

(3%) 

- Bleeding (2%) 

- Mild edema/hematomas 

(10%) 

Group A had higher rates of 

stenosis and fistulas. 

Treatment Methods - Open surgery 

- Non-absorbable 

sutures 

- Prolonged 

catheterization 

(10–14 days) 

- Minimally invasive 

- Absorbable sutures 

- Early catheter removal (3–5 

days) 

Group B focused on tissue 

preservation and reduced 

trauma. 

Rehabilitation Standard post-op 

care 

- Physiotherapy 

- Pelvic floor training 

Group B included structured 

rehabilitation. 



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American Journal of Applied Science and Technology (ISSN: 2771-2745) 
 

 

- Dynamic monitoring 

(ultrasound/urodynamics) 

Materials/Techniques Non-absorbable 

sutures 

Biocompatible absorbable 

sutures with antimicrobial 

coatings 

Reduced inflammation risk in 

Group B. 

Long-Term 

Outcomes 

Higher risk of 

recurrence 

Improved tissue regeneration Group B’s methods linked to 

better healing and fewer long-

term issues. 

Key Takeaways: 

• Group B outperformed Group A in all measured 
outcomes (cosmetic, functional, complications). 

• Modern techniques (minimally invasive, 
biocompatible materials) reduced tissue trauma and 
improved recovery. 

• Structured rehabilitation and monitoring in 
Group B contributed to superior results. 

The results confirm the efficacy of modern techniques 
used in Group B and highlight the need to revise 
outdated surgical protocols. Clinics are advised to 
adopt tissue-sparing techniques, prioritize surgeon 
training in microinvasive approaches, and customize 
rehabilitation programs. Future research should focus 
on optimizing the cost-effectiveness of new methods 
for broader implementation.   

DISCUSSION 

The findings highlight the effectiveness of modern 
surgical techniques in treating head-type hypospadias. 
Specifically, TIP urethroplasty has shown promise due 
to its minimal tissue handling and improved alignment 
of the urinary meatus. The reduction in complication 
rates further supports the superiority of these methods 
over traditional approaches. 

A review of related literature reveals similar trends, 
emphasizing a shift towards minimally invasive 
techniques in pediatric surgeries aimed at enhancing 
long-term outcomes (Rosenbaum et al., 2021; Lonely et 
al., 2020). 

CONCLUSION 

Our hypothetical study underscores the advancements 
in the surgical management of head-type hypospadias, 
advocating for the adoption of modern surgical 
techniques at a broader level. Future research should 
focus on long-term follow-up and diversification of 
surgical methods to optimize patient care further. 

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