Hypospadias surgery past, present and futureRoberts, JulianCurrent Opinion in Urology: November 2010 - Volume 20 - Issue 6 - p 483–489 doi: 10.1097/MOU.0b013e32833e4c80 Reconstructive surgery: Edited by Christopher R. Chapple Abstract Author Information Purpose of review Hypospadias surgery has been in continuous evolution for many years with steadily improving reported results. Despite this many unanswered questions on its cause, management and outcomes remain. Recent research has done little to clarify most matters. Recent findings There is increasing evidence of a balance of genetic and developmental factors in the development of hypospadias, but there is doubt whether the incidence of hypospadias is increasing or not. Many technical aspects of hypospadias repair and variations of perioperative management seem to have little effect on outcome, whereas the age at which surgery is performed may. Although efforts are being made to relate anatomical findings to outcome, a lack of objective assessment and standardization is a handicap. Severe hypospadias, particularly that associated with significant chordee, remains challenging although strategies for management are being developed. The future may lie in development of autologous tissue culture for these severe cases. Summary Further development of hypospadias surgery would benefit from objective, standardized methods of describing anatomy and outcome measures to facilitate effective comparison of techniques and procedures. Sheffield Children's NHS Foundation Trust, Sheffield, UK Correspondence to Julian Roberts, BM, MS, FRCS (Eng and Ed), FRCS (paed), Paediatric Surgical Unit, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK Tel: +44 114 2717327; e-mail: firstname.lastname@example.org © 2010 Lippincott Williams & Wilkins, Inc.