Current challenges with proximal hypospadias: we have a long way to go

Summary While major advances have been made in hypospadias surgery, most of these have come in the management of distal hypospadias. There is significant variance in approaches to proximal hypospadias repair. This is to some degree because many of us have realized that the ideal procedure to repair proximal hypospadias has not yet been determined. This article reviews the history of proximal hypospadias surgery, comparing single-stage and two-stage surgical approaches, and the authors’ current technique for proximal hypospadias repair is presented. Furthermore, available tools for hypospadias research are evaluated and the areas identified that require research efforts to improve outcomes.