Long-Term Outcomes of the Glanular Rotation Procedure (GRP) for Glanular and Coronal Hypospadias

Introduction: Distal hypospadias repair aims at restoring both function and cosmesis. The Glanular RotationProcedure (GRP) was introduced to avoid urethral tubularization, potentially minimizing complications andenhancing aesthetic results. This study presents a comprehensive 10-year follow-up of GRP outcomes.Aim of work: To study the long term effect of glanular rotation procedure (GRP) for glanular and coronalhypospadias.Patients and methods: Ninety-six consecutive patients with glanular or coronal hypospadias underwent GRP atAin Shams University Hospitals from January 2013–December 2015. Ethical approval and informed consent wereobtained. Primary endpoints included late complications (meatal stenosis, regression, dehiscence); secondaryendpoints comprised detailed PPPS subdomain scores and objective uroflowmetry in a subset. Kaplan–Meieranalysis evaluated complication-free survival. Subgroup analyses compared glanular versus coronal cases, andearly (<5 years) versus late (>5 years) complication timing.Results: Follow-up completion in 89/96 patients (92.7%) yielded an overall complication rate of 5.2%. DetailedPPPS median scores were 4 (meatus), 4 (glans shape), 3.8 (skin), and 3.9 (overall). Uroflowmetry in 30 adolescentsdemonstrated mean Qmax 12.5±2.1 mL/s. Kaplan–Meier survival rates were 97.9%, 95.8%, and 93.7% at 1, 5,and 10 years, respectively, with no significant difference between glanular and coronal groups (p=0.13). Latecomplications (>5 years) accounted for 40% of events.Conclusion: GRP yields durable, reproducible outcomes with low morbidity and superior cosmetic metrics.Extended follow-up is essential to detect late complications, particularly in coronal repairs.