A newborn boy is noted to have hypospadiac meatus at the coronal sulcus with a hooded prepuce dorsally and no chordee. The parents ask about routine neonatal circumcision. What should they be advised?
- A Circumcision should be deferred because the preputial skin is used for surgical repair ✓
- B Circumcision should be performed now to reduce infection risk
- C Circumcision makes no difference to future surgery
- D Circumcision should be done now only if the meatus opens at the penoscrotal junction
Correct answer: A. Circumcision should be deferred because the preputial skin is used for surgical repair
Explanation
In hypospadias the dorsal hooded prepuce provides vascularised skin flaps that form part of standard repair techniques such as the Snodgrass procedure, so neonatal circumcision must never be performed. Repair is planned electively between roughly 6 and 18 months of age using the foreskin tissue. This advice applies to all degrees of hypospadias, not only proximal forms, making option D wrong, and option C is false because loss of the prepuce complicates reconstruction.
Reference: Campbell-Walsh Urology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.