Classification of hypospadias is based on the location of meatus.

If the opening is in the glans but not at the tip, the hypospadias is considered mild or grade 1. If the opening is in the distal half of the penis, the hypospadias is considered moderate or grade 2.If the opening is between the anus and the middle of the penis , the hypospadias is severe or grade 3.

.

Various classifications of hypospadias (courtesy of Prof. A. Hadidi)

85% of all cases of hypospadias are mild and moderate forms. Severe forms constitute only 15% of all cases of hypospadias.

Balanic Hypospadias / Grade 1 - pre-and postoperative aspects

Proximal Hypospadias / Grade 3- pre-and postoperative aspects

Besides the abnormal opening of the urethra from the perineum to the glans in hypospadias one can see:

51

• Penile curvature may be superficial involving only the skin or deep, involving the deep structures of the penis

There are cases where the quality of the uretra is questionable . In this cases the urethra must be excised till normal tissues , and the real place of the meatus is considered that obtained after this excision and is located more to the root of the penis

• · deep chordee superficial                         chordee unhealthy urethra

  
  

  · The glans may have a deep, or less deep ventral groove, or may be flat, without ventral groove.

  
  

61

• In some rare cases one can see penoscrotal transposition : the penis is placed between or in some cases under the scrotum.This anomaly is encountered especially in cases of severe hypospadias

  
  

  ·