Penile Shaft Hypospadias in Children: Anatomical Classification, Surgical Reconstruction Techniques, Postoperative Complications, and Long-Term Functional Outcomes

Penile shaft hypospadias is a congenital malformation of the male external genitalia characterized by an abnormally positioned urethral meatus on the ventral surface of the penile shaft. It is commonly associated with ventral curvature of the penis, incomplete foreskin development, and abnormal distribution of penile skin. The severity of the condition depends on the anatomical location of the meatus, the degree of chordee, penile curvature, glans configuration, and the quality of available urethral plate tissue. Hypospadias management requires detailed anatomical assessment and individualized surgical planning. Modern reconstructive techniques include tubularized incised plate urethroplasty, onlay island flap repair, staged urethroplasty, and other tissue-based reconstruction methods. The choice of procedure depends on the severity of the deformity, urethral plate characteristics, curvature, previous operations, and surgeon experience. Postoperative complications may include urethrocutaneous fistula, meatal stenosis, glans dehiscence, urethral stricture, diverticulum, recurrent curvature, and cosmetic dissatisfaction. Long-term follow-up is essential to evaluate urinary function, penile appearance, sexual health, psychological well-being, and patient satisfaction. This article reviews the anatomical classification, diagnostic assessment, surgical reconstruction techniques, postoperative complications, and long-term functional outcomes of penile shaft hypospadias in children.