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Surgery Complications: Glans Dihescence
postedOn: 2025-6-5   updatedOn: 2025-6-16   includedIn: Post-surgery Complications
wordsCount: 370   readingTime: 2 mins   viewers:

This post briefly introduces one of the common post-surgery complications, glans dehiscence.

What Is Glans Dehiscence (GD)?

Glans dehiscence is a known complication after hypospadias surgery, where the stitched head of the penis (glans) partially or completely comes apart. During surgery, the glans is closed around a newly created urine channel. If the closure doesn’t stay intact, the opening may shift back to a lower position. Pictures of GD are shown below.

Fistula example
Fistula example 2
Fistula example
Fistula example 2

What Are The Risk Factors?

Several factors can increase the chance of glans dehiscence:

  • Location of the original urethral opening: If the opening is further down the shaft (proximal hypospadias) instead of near the tip (distal), the surgery is more complex, and the risk of the glans coming apart is higher.
  • Redo surgery: If this is not the first surgery, the risk goes up. This is likely because the tissues are already scarred or not as healthy, making healing harder.
  • Other factors mentioned in the research papers include glans width, urethral plate width, surgery before 6 months old or post-puberty, and so on.

How Common Is It?

The occurrence rate varies by study, but glans dehiscence happens in about 5% to 20% of cases. It’s one of the most common reasons children need a second surgery after hypospadias repair.

When Does It Occur?

Glans dehiscence usually becomes noticeable within a few weeks to a few months after surgery, often during follow-up visits or as the child grows.

Does It Always Need Treatment?

Not always.

  • GD doesn’t always cause problems and might even improve urinary flow, so watchful waiting can be a valid option. Regular long-term follow-up is recommended, especially into puberty.
  • Consider repair if the child experiences urinary problems (like a poor stream) or is upset about how it looks.
  • It is important to be evaluated by at least one surgeon to make informative decision on the treatment.

References

Surgery Complications
Surgery Complications: Fistula