Response to letter re ‘Nomogram of paediatric male urethral size: A systematic review’

Published:November 24, 2021DOI:https://doi.org/10.1016/j.jpurol.2021.11.008
      We thank our colleagues for their comments regarding our recent systematic review on paediatric male urethral size [
      • O'Hagan L.A.
      • Larsen P.D.
      • Nataraja R.M.
      • Pacilli M.
      • Taghavi K.
      Nomogram of paediatric male urethral size: a systematic review.
      ]. Unfortunately, as noted in the manuscript, the nature of the referenced data did not allow for a formal meta-analysis to be conducted. Therefore, our aims were to synthesise the body of literature on paediatric male urethral size, and to provide a nomogram for the busy paediatric urologist. We welcome comments highlighting for the reader the existing literature (both historical and recent) regarding the “septum glandis” which is formed by thin ligamentous tissue. We have noted and referenced broader work in this field with interest, but do wish to re-enforce that hypospadias was excluded from the formal systematic review, as our aim was to summarise studies regarding the normal paediatric urethral meatus. Furthermore, although the histological nature of the distal urethra, fossa navicularis, and urethral meatus are equally interesting [
      • Lee S.H.
      • Ha T.J.
      • Koh K.S.
      • Song W.C.
      Ligamentous structures in human glans penis.
      ], they deserve separate attention with regards to their implications to compliance and ultimate effects on flow dynamics [
      • Özbey H.
      • Arlı O.T.
      “Fossa navicularis” and “septum glandis”: a flow control valve for the male urethra?.
      ].
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      References

        • O'Hagan L.A.
        • Larsen P.D.
        • Nataraja R.M.
        • Pacilli M.
        • Taghavi K.
        Nomogram of paediatric male urethral size: a systematic review.
        J Pediatr Urol. 2021; (in press)https://doi.org/10.1016/j.jpurol.2021.10.014
        • Lee S.H.
        • Ha T.J.
        • Koh K.S.
        • Song W.C.
        Ligamentous structures in human glans penis.
        J Anat. 2019; 234: 83-88https://doi.org/10.1111/joa.12896
        • Özbey H.
        • Arlı O.T.
        “Fossa navicularis” and “septum glandis”: a flow control valve for the male urethra?.
        Med Hypotheses. 2020; 140: 109642https://doi.org/10.1016/j.mehy.2020.109642

      Linked Article

      • Configuration of the glans and size of the urethral meatus
        Journal of Pediatric Urology
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          I read with great interest the article recently published as a meta-analysis in the Journal of Pediatric Urology with the title “Nomogram of pediatric urethral size: a systematic review” [1]. However, I have to say that a meta-analysis can be discarded by a simple observation that has been overlooked for decades. Apparently, the “septum glandis” of the penis has not been considered in any of the studies of hypospadias since it was first described in 1877 [2]. The reason it was overlooked in pediatric patients should be because of its noticeable appearance in adults, not children.
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