Correlation between anogenital distance and severity of hypospadias in male children

Abstract

Previous studies have shown an association between anogenital distance (AGD) and types of hypospadias. This study aims to determine whether AGD can be used to predict the severity of hypospadias in male children. We used a cross-sectional study design to evaluate (43) children with hypospadias. The severity of hypospadias based on the meatal position before surgery was classified using the meatal score of the glans-urethral meatal-shaft (GMS) classification into four groups of M1–M4. Three AGD parameters viz: ano-scrotal distance (ASD), the ano-penal distance 1 (APD1) and the ano-penal distance 2 (APD2) were measured using a digital calliper. The glanulomeatal distance 1 (GMD1) before and the glanulomeatal distance 2 (GMD2) after chordee correction were calculated for any change in the position of the meatus. Data were collected over 18 months and analysed using Statistical Package for Social Sciences (IBM SPSS) version 25 software. A P-value of < 0.05 was considered to be statistically significant. The mean ano-scrotal distance (ASD), ano-penile distance 1 (APD1) and ano-penile distance 2 (APD2) were 35.0 ± 7.11 mm, 66.0 ± 13.0 mm and 82.05 ± 14.0 mm, respectively. The parameters of AGD and AGD index progressively decreased with increasing meatal score but these decreases were not statistically significant across the four categories of meatal score. Statistically significant, moderately negative correlations were observed between GMD2 and mean ASD (R = − 0.394, P ≤ 0.009), APD1 (R = − 0.308, P ≤ 0.045) and APD2 (R = − 0.391, P ≤ 0.010). There were also statistically significant predictive relationships between GMD2 (intra-operative meatal position) with ASD (R2 = 0.155, P ≤ 0.009), APD1 (R2 = 0.095, P ≤ 0.045) and APD2 (R2 = 0.153, P ≤ 0.010). The study demonstrated a significant relationship between the AGD and meatal position. Therefore, AGD may be used to predict the intra-operative meatal position and hence, the severity of hypospadias before surgery.