Can separation of the scrotal sac in proximal hypospadias reliably predict the need for urethral plate transection?

Techniques that commit to urethral plate transection are criticized because they preclude using the urethral plate. In our study presence of SSS was predictive for the need to transect the plate. Obviously one can decide to keep the urethral plate at all cost, and mobilize it more than we did, or accept more residual curvature, but in reality our aim was to determine a preoperative marker allowing us to define a patient category. We believe presence of SSS is a marker of severity, and that this “severity” translates into “a less usable urethra”. As recent studies caution us about the evolution of the reconstructed native urethra and the possibility that it may not grow as well as the other penile tissues, we believe this extra information could influence the surgeon's decision as to the most appropriate technique for each patient.Table. Results of bivariate analysis.ResultsTotalNo SSSSSSpAge, years4.23.44.70.68Urethral transection17 (58.6%)2 (18.2%)15 (83.3%)0.001A p-value <0.05 was considered statistically significant.