Microscopic studies of curvature-causing structures in hypospadias.

Microscopical studies were performed in a consecutive series of 20 hypospadiacs (3 crypto-hypospadias; 9 glandular; 7 penile; and 1 perineal) with curvature, 3 of whom also exhibited torsion. Specimens for the investigation were dissected free at the first operation and it was found that the binding tissues on the ventral side of the penis reached about half of the circumference of the penile shaft, stretching longitudinally from the coronal sulcus, passing the original meatus and extending proximally on the shaft. The specimens from the 17 hypospadias with curvature only exhibited a symmetric pattern in the tissue plate, while in 3 hypospadias with curvature and torsion an asymmetry was found, with longer lateral tissue plates in the contralateral direction to the torsion. With two exceptions, the microscopical investigation showed the same principal lesions: proximally the urethra had a normal circular corpus spongiosum, but at varying distances distally the ventral parts of the corpus spongiosum were thinned out, and disappeared and the lateral parts were disorganized, penetrating out laterally in the plate of connective tissue. The dorsal part of the corpus spongiosum was thinned and was found to continue distally from the meatus to the coronal sulcus. In the 3 hypospadias with curvature and torsion the microscopical findings were principally the same as in the cases with curvature only, but with longer lateral penetration on the side contralateral to the direction of the torsion.