Long-Term Outcomes of the Glanular Rotation Procedure (GRP) for Glanular and Coronal Hypospadias

Document Type : Original Article

Authors

Department of Pediatric Surgery, Ain Shams University Hospitals, Cairo, Egypt

10.21608/asjs.2025.393720.1212

Abstract

Introduction: Distal hypospadias repair aims at restoring both function and cosmesis. The Glanular Rotation
Procedure (GRP) was introduced to avoid urethral tubularization, potentially minimizing complications and
enhancing aesthetic results. This study presents a comprehensive 10-year follow-up of GRP outcomes.
Aim of work: To study the long term effect of glanular rotation procedure (GRP) for glanular and coronal
hypospadias.
Patients and methods: Ninety-six consecutive patients with glanular or coronal hypospadias underwent GRP at
Ain Shams University Hospitals from January 2013–December 2015. Ethical approval and informed consent were
obtained. Primary endpoints included late complications (meatal stenosis, regression, dehiscence); secondary
endpoints comprised detailed PPPS subdomain scores and objective uroflowmetry in a subset. Kaplan–Meier
analysis evaluated complication-free survival. Subgroup analyses compared glanular versus coronal cases, and
early (<5 years) versus late (>5 years) complication timing.
Results: Follow-up completion in 89/96 patients (92.7%) yielded an overall complication rate of 5.2%. Detailed
PPPS median scores were 4 (meatus), 4 (glans shape), 3.8 (skin), and 3.9 (overall). Uroflowmetry in 30 adolescents
demonstrated mean Qmax 12.5±2.1 mL/s. Kaplan–Meier survival rates were 97.9%, 95.8%, and 93.7% at 1, 5,
and 10 years, respectively, with no significant difference between glanular and coronal groups (p=0.13). Late
complications (>5 years) accounted for 40% of events.
Conclusion: GRP yields durable, reproducible outcomes with low morbidity and superior cosmetic metrics.
Extended follow-up is essential to detect late complications, particularly in coronal repairs.

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