Correlation of Glans-Urethral Meatus-Shaft scoring system for Hypospadias with Post-operative outcome

Abstract

Background:There are numerous techniques for hypospadias repair and the outcome of urethroplasty depends on patient related factors and surgeon related factors. Currently there is no widely accepted scoring system for assessing the severity of hypospadias. Objective: Present study was aimed to classify the severity of hypospadias according to GMS score and correlate the score with post-operative complications. Methods:100 males with distal to mid-shaft hypospadias consecutively selected for Urethroplasty were included in this prospective study during September 2015 to March 2017. The Glans size/groove, Urethral plate width, location of meatus and severity of chordee were evaluated individually before reconstruction. After surgery and during follow-up visits, the subsequent transient and persistent complications were recorded. Results:The mean GMS score in group A, B and C was 4.78 (± 0.69), 8.19 (± 0.90) and 10.43 (± 0.51) respectively. In Group A, UC fistula was seen in 7.4% of patients whereas In Group B and Group C, UC Fistula was seen in 46.9% and 92.9% patients respectively. Meatalstenosis was not seen in patients in Group A and Group C patients. In Group B, meatal stenosis was seen in 15.6% patients. Glans Dehiscence was not seen in patients in Group A and Group C. In Group B, Glans Dehiscence was seen in 6.2% patients. Stricture Urethra was seen in 9.3% patients in group A . In Group B and Group C, Stricture Urethra was seen in 43.8% and 92.9% patients respectively. Conclusion: The Glans-Urethral Meatus-Shaft (GMS) classification provides a means by which hypospadias severity and reporting can be standardized, which may improve inter-study comparison of reconstructive outcomes. There is a strong correlation between complication risk and total GMS score.